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Elastin staining patterns in primary cicatricial alopecia.

Maxwell A Fung1, Victoria R Sharon2, Mondhipa Ratnarathorn2

  • 1Department of Dermatology, University of California, Davis, Sacramento, California; Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, California.

Journal of the American Academy of Dermatology
|September 17, 2013
PubMed
Summary
This summary is machine-generated.

Elastic tissue staining reveals distinct fibrosis patterns in scarring alopecia. Broad tree trunk-shaped fibrosis is specific for central centrifugal cicatricial alopecia (CCCA), aiding diagnosis in difficult cases.

Keywords:
CCCADLEEVGFFAH&ELPPVerhoeff elastic van Giesoncentral centrifugal cicatricial alopeciacicatricial alopeciadermatopathologydiscoid lupus erythematosuselastinfrontal fibrosing alopeciahematoxylin-eosinlichen planopilarisscarring alopeciatraction alopecia

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Area of Science:

  • Dermatopathology
  • Histopathology
  • Hair Biology

Background:

  • Diagnosing cicatricial (scarring) alopecia via biopsy can be challenging, especially in late disease stages.
  • Distinguishing between lymphocytic and neutrophilic patterns is often insufficient for specific diagnosis.

Purpose of the Study:

  • To identify and document specific patterns of scarring in primary cicatricial alopecia using elastic tissue staining.
  • To correlate these fibrosis patterns with specific diagnoses of cicatricial alopecia.

Main Methods:

  • Elastic tissue (Verhoeff van Gieson) staining was performed on 58 vertical biopsy specimens of cicatricial alopecia.
  • Fibrosis patterns (perifollicular: wedge-shaped vs. broad tree trunk-shaped; diffuse) were analyzed.
  • Staining patterns were compared with expert clinical diagnoses, including central centrifugal cicatricial alopecia (CCCA), lichen planopilaris, and others.

Main Results:

  • Wedge-shaped perifollicular fibrosis was observed in lichen planopilaris and CCCA.
  • Broad tree trunk-shaped perifollicular fibrosis was predominantly identified in CCCA.
  • The study noted limitations due to its retrospective nature, precluding disease staging.

Conclusions:

  • Fibrosis patterns visualized by elastin staining appear disease-specific in primary cicatricial alopecia.
  • Broad tree trunk-like perifollicular fibrosis is a specific indicator for CCCA.
  • Elastin staining is a valuable ancillary tool for evaluating late-stage scarring alopecia in routine biopsy specimens.