{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T09:07:47Z","timestamp":1780304867599,"version":"3.54.0"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alopecia can significantly affect a patient's quality of life, underscoring the clinical importance of the optimal scalp biopsy technique. As histopathology remains the gold standard, selecting the most efficient and resource\u2010conscious biopsy processing technique is essential for delivering high\u2010value care. The optimal processing technique remains controversial. Seven distinct methods reported between 1984 and 2022 exist, but comprehensive head\u2010to\u2010head comparative studies assessing resource utilization have yet to be conducted. This study extends prior comparative investigations by systematically evaluating seven scalp biopsy processing techniques to identify the most efficient and diagnostically adequate method, addressing critical gaps in histopathologic workflows to advance value\u2010based patient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty standard 4\u2009mm punch biopsies were performed and processed for seven alopecia biopsy techniques\u2014Diagonal, Frishberg, Headington, HoVert, St. John's (two biopsy specimens), Thompson and Tosti, and Tyler\u2014to assess diagnostic adequacy (i.e., full visualization of the folliculosebaceous unit in upfront slides), resource consumption, and histotechnologist time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Diagnostic adequacy was reliably achieved using the Diagonal, HoVert, St. John's, and Tyler methods. The Tyler method required the least amount of time (&lt;\u200915\u2009min) and fewest materials (one paraffin block and two slides) compared to the other techniques that yielded diagnostically adequate slides.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study demonstrates that the Tyler method is the most efficient and resource\u2010sparing technique for diagnostic adequacy in alopecia biopsies, supporting its adoption as a high\u2010value care initiative. These results underscore the potential to enhance laboratory efficiency, optimize diagnostic precision, and promote cost\u2010effective practices in pathology laboratories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cup.70089","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T04:40:26Z","timestamp":1774932026000},"page":"640-647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systematic \u201cHead\u2010to\u2010Head\u201d Comparison of Scalp Biopsy Techniques for Alopecia Diagnosis: Diagnostic Adequacy, Efficiency, and Resource Utilization"],"prefix":"10.1111","volume":"53","author":[{"given":"Lauren E.","family":"Heusinkveld","sequence":"first","affiliation":[{"name":"Pathology Service Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia K.","family":"Harris","sequence":"additional","affiliation":[{"name":"Pathology Service Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Walsh","sequence":"additional","affiliation":[{"name":"Pathology Service Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Anim","sequence":"additional","affiliation":[{"name":"Pathology Service Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Keko","sequence":"additional","affiliation":[{"name":"Carl J. Shapiro Department of Orthopaedic Surgery Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalynn M.","family":"Nazarian","sequence":"additional","affiliation":[{"name":"Department of Dermatology Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.12075"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1984.01650400031009"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2023\u20100339\u2010OA"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.04.100"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0190\u20109622(96)90328\u2010x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102559.2009.03439.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100560.2010.01669.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100560.2011.01839.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.12.033"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2016.2797"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2005.03.007"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190\u20109622(93)70106\u20104"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.dad.0000154398.60712.11"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/JLP.JLP_4_17"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2019\u20100140\u2010CP"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.5858\/2010\u20100288\u2010CP.1"},{"key":"e_1_2_10_18_1","unstructured":"R. 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