{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:32:50Z","timestamp":1787070770610,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patchy\/focal alopecia can be noncicatricial or cicatricial. Trichopathology may play an important role in confirming and\/or establishing the diagnosis of cicatricial alopecia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>The aim of this study was to study the trichopathologic features of common cicatricial conditions presenting with patchy scalp alopecia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted over a period of 1 year in the department of dermatology and pathology in a tertiary care hospital in North India. Adult patients (age &gt;18 years) presenting with patchy cicatricial alopecia as well as clinically doubtful noncicatricial conditions over the scalp were included in this study. In doubtful cases of noncicatricial alopecia, a single 4-mm punch biopsy was performed for transverse sectioning with hematoxylin and eosin stain. In all cases of cicatricial alopecia, two 4-mm punch biopsies were performed, one for transverse sectioning and the second for vertical sectioning and direct immunofluorescence (DIF). The final diagnosis was made on the basis of the trichopathologic findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 23 cases were included in our study with the majority (52.2%) being in the age group of 20\u201330 years. The mean age at diagnosis was 30.5 \u00b1 11.38 years. On the basis of trichopathologic findings, a final diagnosis was made in 18 (78.3%) cases. However, 5 (21.7%) cases remained undiagnosed and were labeled as nonspecific. According to the final diagnosis based on the trichopathologic findings, maximum cases were of discoid lupus erythematosus (DLE) (26.1%), followed by lichen planopilaris (21.7%), pseudopelade of Brocq (13%), alopecia areata (8.7%), folliculitis decalvans (4.3%), and traction alopecia (4.3%). Trichopathologic examination revealed hyperkeratosis (60%), basal cell vacuolization (55%), epidermal atrophy (55%,) perifollicular lymphocytic infiltrate (30%), pigment incontinence (30%), perifollicular fibrosis (25%), and thickened basement membrane (25%). Only four cases showed deposits of immunoreactants in DIF and all four were finally diagnosed as DLE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Trichopathology along with special stain is a useful tool in the diagnosis of patchy alopecia and must be carried out in cases where diagnosis is in doubt clinically, particularly in cases of cicatricial alopecia. DIF may have a supportive role in histopathologically inconclusive cases and should be carried out, particularly when DLE is suspected. Trichopathology in combination with DIF is an important tool in the diagnosis of the majority of cases of cicatricial as well as clinically doubtful cases of noncicatricial alopecia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijt.ijt_123_23","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T15:00:15Z","timestamp":1750690815000},"page":"58-63","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Trichopathology of Cicatricial Alopecia"],"prefix":"10.4103","volume":"17","author":[{"given":"Preksha","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Dermatology and STD, Dr. N. C. Joshi Memorial Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taru","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpi","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Pathology, Lady Hardinge Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit Kumar","family":"Meena","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram","family":"Chander","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deeksha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pathology, Lady Hardinge Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"R1-20250628","first-page":"356","article-title":"Diagnosing and treating hair loss","volume":"80","author":"Mounsey","year":"2009","journal-title":"Am Fam Physician"},{"key":"R2-20250628","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1440-0960.1998.tb01476.x","article-title":"Acquired scalp alopecia. Part I:A review","volume":"39","author":"Sullivan","year":"1998","journal-title":"Australas J Dermatol"},{"key":"R3-20250628","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/00000372-200606000-00051","article-title":"Histopathologic evaluation of alopecias","volume":"28","author":"Sellheyer","year":"2006","journal-title":"Am J Dermatopathol"},{"key":"R4-20250628","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.sder.2006.01.003","article-title":"Clinical approach to the patient with alopecia","volume":"25","author":"Han","year":"2006","journal-title":"Semin Cutan Med Surg"},{"key":"R5-20250628","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.sder.2006.01.006","article-title":"The histopathology of primary cicatricial alopecia","volume":"25","author":"Sperling","year":"2006","journal-title":"Semin Cutan Med Surg"},{"key":"R6-20250628","first-page":"2","article-title":"Alopecia:Histologic diagnosis by transverse sections","volume":"13","author":"Templeton","year":"1996","journal-title":"Semin Diagn Pathol"},{"key":"R7-20250628","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1056\/NEJM199909233411307","article-title":"Treatment of hair loss","volume":"341","author":"Price","year":"1999","journal-title":"N Engl J Med"},{"key":"R8-20250628","doi-asserted-by":"crossref","first-page":"21","DOI":"10.4103\/2277-8632.94171","article-title":"Clinico-pathological study of acquired primary cicatricial alopecias","volume":"1","author":"Sowjanya","year":"2012","journal-title":"J Dr NTR Univ Health Sci"},{"key":"R9-20250628","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1111\/j.1365-2230.2011.04154.x","article-title":"Vertical versus. transverse sections of scalp biopsy specimens:A pilot study on the comparison of the diagnostic value of two techniques in alopecia","volume":"36","author":"\u00d6zcan","year":"2011","journal-title":"Clin Exp Dermatol"},{"key":"R10-20250628","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/j.1468-3083.2009.03499.x","article-title":"A study of serial vertical sectioning of scalp biopsies to increase the histological diagnostic yield in alopecias","volume":"24","author":"Bathish","year":"2010","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R11-20250628","first-page":"272","article-title":"A clinical and histopathological study of cicatricial alopecia","volume":"23","author":"Puri","year":"2013","journal-title":"J Pak Assoc Dermatol"},{"key":"R12-20250628","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1111\/j.1600-0560.2010.01640.x","article-title":"'Follicular Swiss cheese'pattern \u2013Another histopathologic clue to alopecia areata","volume":"38","author":"M\u00fcller","year":"2011","journal-title":"J Cutan Pathol"},{"key":"R13-20250628","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/S0190-9622(97)70219-6","article-title":"Eosinophils in fibrous tracts and near hair bulbs:A helpful diagnostic feature of alopecia areata","volume":"37","author":"Elston","year":"1997","journal-title":"J Am Acad Dermatol"},{"key":"R14-20250628","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1046\/j.1529-8019.2001.01037.x","article-title":"The histopathology of alopecia areata in vertical and horizontal sections","volume":"14","author":"Whiting","year":"2001","journal-title":"Dermatol Ther"},{"key":"R15-20250628","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.sder.2006.01.005","article-title":"The histopathology of noncicatricial alopecia","volume":"25","author":"Eudy","year":"2006","journal-title":"Semin Cutan Med Surg"},{"key":"R16-20250628","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1111\/j.1529-8019.2008.00203.x","article-title":"Cicatricial alopecia:Classification and histopathology","volume":"21","author":"Somani","year":"2008","journal-title":"Dermatol Ther"},{"key":"R17-20250628","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/j.1600-0560.1994.tb00243.x","article-title":"Scarring alopecia:A classification based on microscopic criteria","volume":"21","author":"Templeton","year":"1994","journal-title":"J Cutan Pathol"},{"key":"R18-20250628","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0738-081X(00)00131-0","article-title":"Lymphocytic mediated alopecia:Histological classification by pattern analysis","volume":"19","author":"Kossard","year":"2001","journal-title":"Clin Dermatol"},{"key":"R19-20250628","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1034\/j.1600-0560.2000.027003147.x","article-title":"Elastic tissue in scars and alopecia","volume":"27","author":"Elston","year":"2000","journal-title":"J Cutan Pathol"},{"key":"R20-20250628","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/j.jaad.2013.07.018","article-title":"Elastin staining patterns in primary cicatricial alopecia","volume":"69","author":"Fung","year":"2013","journal-title":"J Am Acad Dermatol"},{"key":"R21-20250628","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1159\/000086436","article-title":"Value of direct immunofluorescence for differential diagnosis of cicatricial alopecia","volume":"211","author":"Trachsler","year":"2005","journal-title":"Dermatology"},{"key":"R22-20250628","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jaad.2003.04.001","article-title":"Primary cicatricial alopecias:Clinicopathology of 112 cases","volume":"50","author":"Tan","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"R23-20250628","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1046\/j.1365-2133.2003.05277.x","article-title":"A multiparametric approach is essential to define different clinicopathological entities within pseudopelade of Brocq","volume":"148","author":"Salim","year":"2003","journal-title":"Br J Dermatol"}],"container-title":["International Journal of Trichology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijt.ijt_123_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:36:19Z","timestamp":1787067379000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijt.ijt_123_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijt.ijt_123_23","relation":{},"ISSN":["0974-7753","0974-9241"],"issn-type":[{"value":"0974-7753","type":"print"},{"value":"0974-9241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2023-11-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}