The following is a summary of “Histopathologic diagnosis of traction alopecia: An evidence-based model,” published in the OCTOBER 2023 issue of Dermatology by Pitch, et al.

Traction alopecia (TA) is a prevalent form of hair loss, yet there is a dearth of clearly defined histopathologic criteria to diagnose it objectively. For a study, researchers sought to establish whether the presence of pauci-follicular units (PFUs) could serve as a definitive diagnostic criterion for TA. PFUs are characterized by noninflamed follicular units with an intact sebaceous gland but possessing fewer than two hair follicles.

A retrospective analysis involving 25 cases of TA and 25 cases of “normal scalp” was undertaken. Data were gathered regarding all follicles, encompassing their size, growth phase, sebaceous glands, and the total count of follicular units.

Upon contrasting the data between TA and normal scalp, it was discerned that cases of TA exhibited a notably higher number of PFUs (median 6 vs. 0, P < .001). The presence of PFUs was identified as a practical and readily recognizable diagnostic marker for the identification of TA. The study did not conduct a comparative analysis of these findings with other forms of alopecia.

The presence of PFUs within a scalp biopsy can be harnessed to definitively confirm the diagnosis of TA.

Source: jaad.org/article/S0190-9622(23)01185-4/fulltext