Follicular Melanocytes in Frontal Fibrosing Alopecia: An Immunohistochemical Study With Trichoscopic Correlation. (28th April 2022)

• Record Type: Journal Article
• Authors: Salas-Callo, Corina Isabel; Carvalho Quintella, Danielle; Saceda-Corralo, David; Pirmez, Rodrigo
• Is Part Of: American journal of dermatopathology. Volume 44:Number 4(2022)
• Page Start: 254
• Page End: 256
• Publication Date: 2022-04-28
• Subjects: frontal fibrosing alopecia -- peripilar white halos -- trichoscopy -- hypopigmentation -- scarring alopecia; Skin -- Diseases -- Periodicals; Histology, Pathological -- Periodicals; 616.50705
• DOI: 10.1097/DAD.0000000000002115
• Languages: English
• ISSNs: 0193-1091

Abstract

Abstract : 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.