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Follicular Melanocytes in Frontal Fibrosing Alopecia: An Immunohistochemical Study With Trichoscopic Correlation
Corina Isabel Salas-Callo1, Danielle Carvalho Quintella2, David Saceda-Corralo3
1Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Hospital da Santa Casa da Misericórdia do Rio de Janeiro, RJ, Brazil.
Background:
Frontal fibrosing alopecia (FFA) is a scarring alopecia that affects the frontotemporal hairline. Clinically, it may develop with cutaneous hypopigmentation of the affected areas, which has been associated with a reduction in the epidermal melanocyte count. In trichoscopy, peripilar white halos can be observed, which have been associated with fibrosis in other scarring alopecias.
Objective:
To evaluate the trichoscopic, histopathological and immunohistochemical characteristics of the peripilar white halos in FFA patients.
Materials And Methods:
We conducted a descriptive cross-sectional study that included 12 patients with FFA presenting peripilar white halos. Two 2-mm punch trichoscopy-guided biopsies were performed in all patients, one fragment for vertical section and another for horizontal section. The vertical sections were stained with Fontana-Mason and Melan-A.
Results:
On trichoscopic examination, peripilar white halos ≤ 1 mm in size were observed on the affected scalp. In vertical sections, a reduction in basal melanin pigmentation and a decrease in the melanocyte count in the upper segment of the hair follicle were observed with Fontana-Masson staining and Melan-A immunostaining, respectively.
Limitations:
The small sample size and absence of a control group.
Conclusion:
This study shows follicular melanocyte involvement in FFA, and this finding may be associated with the peripilar white halos observed in trichoscopy.
