Hair Pathology
A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".
Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 32277
Special Issue Editor
Special Issue Information
Dear Colleagues,
The basics:
Hair pathology is an exciting subdivision of dermatopathology that is dedicated to diagnosing hair disorders (scarring and non-scarring alopecias) on histologic slides obtained from scalp biopsies. Scalp biopsy is the diagnostic standard for scarring alopecias. The goal is to perform a biopsy in very early cases with only subtle clinical and trichoscopic features in order to establish an early diagnosis. A scalp biopsy is also useful in diffuse non-scarring alopecia to assess follicular miniaturization based on follicular counts and ratios, and for detection of adjunct features with implication for the therapy such as the presence of peri-infundibular lymphohistiocytic infiltrate in some biopsies from androgenetic alopecia.
How is it done?
Hair pathologists are trained to evaluate the scalp biopsies through horizontal sections, a procedure first introduced by Headington in 1984. In no-scarring alopecias, one 4 mm punch biopsy from the parietal scalp will usually be processed for horizontal sections since vertical sections are not useful in no-scarring alopecias. If scarring alopecia is suspected, trichoscopy (hair and scalp dermoscopy) should be used to identify the most optimal site for the biopsy. Usually, a dermoscopy-guided 4 mm punch biopsy will be obtained and processed in horizontal sections to ascertain a larger area for evaluation and even diagnosis of focal disease (individually affected follicular units). If the working diagnosis is unclear, the clinician would sometimes obtain two biopsies—one for horizontal and one for vertical sections.
The “power” of hair pathology
Hair pathology is the ultimate tool in assembling the puzzle of the clinical and trichoscopic signs using follicular morphology. This allows for the most optimal diagnosis. By seeing the patient and performing a scalp biopsy, I am convinced that we achieve the most insight for designing the best possible treatment regimen. Hair pathology is also a crucial part of all breakthroughs in hair research as it provides the model to prove hypotheses generated ex vivo in the lab or in vivo in practice. I believe that there is an urgent demand for more morphological observations that can provide translational researchers with a rationale for experimental work toward curing alopecia.
This issue is dedicated to hair pathology and aims to take you on a journey in the fascinating world of hair morphology.
Prof. Dr. Mariya Miteva
Guest Editor
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Keywords
- hair follicle
- scalp
- alopecia
- hair loss
- pathology
- histology
- biopsy
- horizontal sections
- hair morphology
- hair anatomy
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