Observation of Follicular Morphology of Alopecia Areata by the Duration of the Lesion

Kang, Kwnag Suk; Ihm, Chull Wan

Abstract

Students of alopecia areata (AA) face confusion in the understanding of the follicular status of the lesion. This confusion partly is related to varing histopathological descriptions given by different authors. In an attempt to clarify these varing descriptions, we made our own observations on 45 scalp biopsies from the patients with AA. The lesions were devided into four groups by the duration of the alopecia. The results were as in the following. Initial stage (within 2 weeks after the onset, 5 cases) showed mostly the catagen stage of terminal hair follicles and pigmentary incontinence in all cases. Only 2 cases (40%) showed significant cellular infiltrate. Progressive stage (between 2 weeks and several months after onset, 11 cases) showed catagen follicles of terminal hair with the development of miniature follicles among them. Pigmentary incontinence and inflammatory cell infiltrate were seen in 9 cases (82%) and 8 cases (73%) respectively. In established stage (26 cases), miniature follicles were predominant with pigmentary incontinence (73%: 19 cases) and cellular infiltrate (69%: 18 cases). In recovery stage, there were normal anagen follicles with absent or decreased inflammatory cells and pigmentary incontinence. A proposal that hair follicles better be designated not only with their stages but also with their types is presented.