ABSTRACT
Clinicians who contribute even a brief clinical description and differential diagnosis are of considerable assistance to the pathologist. Some clinical features that may be described include:
• Pattern of hair loss • Evidence of inflammation • Evidence of hair breakage (hairs of uneven length) • Evidence of permanent hair loss • Obliteration of follicular ostia • Abnormal hair density
The most important feature is the pattern of hair loss. Hair loss can be diffuse or ‘patterned’. Patterned hair loss implies that the area of alopecia is confined to one or several portions of the scalp, leaving at least a portion of the scalp uninvolved. Truly diffuse hair loss suggests a uniform reduction in hair density over all portions of the scalp. Telogen effluvium (Figure 6.1) is an example of truly diffuse alopecia, with all areas of the scalp showing some thinning of the hair. Patchy alopecia areata is one example of patterned alopecia. The various patterns of thier loss are listed below.
