By Leonard C. Sperling
Diagnosing and treating hair issues is an integral part of either clinical and beauty dermatology perform. seeing that this can be a topic that's hardly or merely superficially lined in the course of residency education, the pathologists and dermatopathologists who needs to review specimens submitted with a scientific prognosis of hair affliction usually discover a hole of their wisdom. The filing dermatologist often needs to act as pathologist in addition to clinician. greater than only a ebook on hair sickness, An Atlas of Hair Pathology with scientific Correlations bridges that hole. the 1st complete evaluate of the microscopic pathology of hair ailment, this e-book serves as a primer, an atlas, and a reference. As a primer, it reports very simple details, together with hair anatomy and the "nuts and bolts" of processing and comparing specimens. As an atlas, it truly is wealthy in images demonstrating simple and complicated histologic positive factors of hair disorder. And, as a reference, it comprises updated info and a evaluation of uncomplicated medical good points that offer a clinical-pathologic correlation. With 365 illustrations from the author's own choice of slides, An Atlas of Hair Pathology with scientific Correlations is the main entire and "user-friendly" source on hair pathology on hand.
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Additional info for An Atlas of Hair Pathology with Clinical Correlations (The Encyclopedia of Visual Medicine Series)
Adv Dermatol 1994; 9:127–57 Sperling L, Solomon A,Whiting D. A new look at scarring alopecia. Arch Dermatol 2000; 136:235–42 Templeton S, Solomon A. Scarring alopecia: a classification based on microscopic criteria. J Cutan Pathol 1994; 21: 97–109 CHAPTER 5 Distinctive or critical histological features and associated diseases Classification schemes are of little value to pathologists trying to extract the diagnosis from a glass slide. The histological features, in conjunction with a brief clinical description, must somehow guide the pathologist to the correct diagnosis.
A generous amount of anesthetic (1–3 ml) should be injected into the deep dermis and superficial fat, and allowed to act for 15–30 minutes before the biopsy is performed. This will minimize bleeding. The blade of the punch biopsy tool should extend through the dermis down into the fat, so that intact bulbs of deeply rooted terminal hairs can be removed. A 4-mm biopsy wound can be easily closed with 3–0 suture because the needle can traverse the wound in a single pass. A suture color that contrasts with the patient’s hair will assist in suture removal 1 week after the biopsy is performed.
The starting point for arriving at a histological diagnosis is recognition of an obvious or dominant histological finding, such as miniaturization of hairs, ‘missing’ hairs, or perifollicular inflammation. Unfortunately, no single histological feature is sufficient to establish a definitive diagnosis in any form of hair loss. However, a differential diagnosis based on one or two histological features will help to create a ‘short list’ of possible diagnoses. Additional histological features characteristic of the entities on the ‘short’ list can then be used to narrow the field of possibilities.