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Distinguishing diffuse alopecia areata (AA) from pattern hair loss (PHL) using CD3+ T cells

par Kolivras, Athanassios ;Thompson, Curtis T
Référence Journal of the American Academy of Dermatology, 74, 5, page (937-944)
Publication Publié, 2016-05

Article révisé par les pairs

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Résumé :

Distinguishing between diffuse subacute alopecia areata (AA), in which the peribulbar infiltrate is absent, and pattern hair loss is challenging, particularly in cases that lack marked follicular miniaturization and a marked catagen/telogen shift. Objective We sought to distinguish diffuse AA from pattern hair loss using CD3+ T lymphocytes. Methods A total of 28 cases of subacute AA and 31 cases of pattern hair loss were selected and a 4-mm punch biopsy was performed. All the specimens were processed using the "HoVert" (horizontal and vertical) technique. In all cases, hematoxylin-eosin and immunohistochemical stains for CD3, CD4, CD8, and CD20 were performed. Results The presence of CD3+ lymphocytes within empty follicular fibrous tracts (stela), even without a concomitant peribulbar infiltrate, is a reliable histopathological clue in supporting a diagnosis of AA (sensitivity 0.964, specificity 1, P ≤.001). Limitations Limited tissue for analysis remained in the clinical sample tissue blocks. Conclusion The presence of CD3+ T-cells within empty follicular fibrous tracts (stela) supports a diagnosis of AA.