Horizontal and Vertical Sections in Alopecia: Study of Fifty Cases with their Clinicopathological Correlation

Objective To compare the histopathological findings in horizontal and vertical sections in cases of alopecia with their clinicopathological correlation. Materials and methods A study of 50 patients was conducted to study the histopathological findings in horizontal and vertical sections in cases of alopecia along with their clinicopathological correlation. Results In our study, major causes of alopecia were lichen planopilaris (22 %), discoid lupus erythematosus (16 %), alopecia areata (16 %), Pseudopelade of Broq (14 %), other causes included folliculitis, psoriasis scalp, nevus sebaceous, spongiotic psoriasiform dermatitis, trichotillomania, post inflammatory dermatoses, lupus profundus, acne keloides, lichen simplex chronicus and solar keratosis. In our study, the histopathological features of alopecia were perifollicular lymphocytic infiltrate in 35 % patients, perifollicular fibrosis in 32 % patients, hyperkeratosis in 20 % patients, necrotic keratinocytes in 18 % and basal cell vacuolization in 16 % patients. Pigment casts were seen in 2 % of cases. Conclusion Lichen planopilaris, Discoid lupus erythematosus were diagnosed better in vertical sections. Alopecia areata was diagnosed better on horizontal sections. Combined vertical and horizontal sections increased the chances of reaching a correct diagnosis.