Histologic features of alopecias: part II: scarring alopecias

Abstract

The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the second part of this review, we describe the histologic features of the main forms of scarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histopathologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder.

Keywords: Acne keloidalis nuchae; Acné necrótico varioliforme; Acné queloideo de la nuca; Alopecia; Alopecia cicatricial centrífuga central; Alopecia mucinosa; Alopecias cicatriciales; Brocq pseudopelade; Celulitis/foliculitis disecante; Central centrifugal cicatricial alopecia; Chronic cutaneous lupus erythematosus; Dermatopathology; Dermatopatología; Dissecting cellulitis/folliculitis; Foliculitis decalvante; Follicular lichen planus; Folliculitis decalvans; Keratosis follicularis spinulosa decalvans; Liquen plano folicular; Lupus eritematoso cutáneo crónico; Necrotizing lymphocytic folliculitis; Pseudopelada de Brocq; Queratosis folicular espinulosa decalvante; Review; Revisión; Scarring alopecia.