MORPHOLOGICAL CHARACTERISTICS OF EPIDERMIS AND DERMIS IN PATIENTS WITH DIFFUSE ALOPECIA, ANDROGENETIC ALOPECIA AND ALOPECIA AREATA

Abstract

Despite the emergence of non-invasive and very informative techniques, such as trichoscopy and confocal microscopy, it is still necessary to use a skin biopsy of the scalp. Currently, there is a lot of information about hystopathology of the scalp in patients with diffuse alopecia, androgenetic alopecia and alopecia areata [1]. Researches mostly aim to study the follicular unit, whereas data on pathological changes in the epidermis, papillary and reticular dermis in the above-mentioned alopecia are rare and scattered. In this connection, the aim of the research was to study morphological characteristics of epidermis and dermis in patients with diffuse alopecia, androgenetic alopecia and alopecia areata. Material and methods. We examined 25 patients (12 women and 13 men) aged 17 to 60 years with not cicatricial alopecia: androgenetic alopecia was observed in 10 patients, alopecia areata - in 9 patients, diffuse alopecia - in 6 patients. The age of the disease ranged from 1 month to 5 years. The control group consisted of 9 people. The review microscopy and morphometry of samples, taken for investigation, were performed using the eyepiece micrometer MOB-1-15xУ4.2. The following indicators in the dermis were evaluated: the presence of lymphohistiocytic infiltrates in the papillary and reticular dermis, mucoid swelling of sclerosis of the papillary dermis, and signs of destruction of hair follicles. Results. The tendency to increase thickness of the epidermis in patients with diffuse alopecia is associated with thickening of the stratum granulosum and especially the stratum corneum. In case of androgenetic alopecia and alopecia areata the tendency to decrease the thickness of the epidermis is associated with a tendency to reduce the thickness of the stratum lucidum. Regardless of the type of alopecia, the thickness of the stratum basale is statistically higher than in the control group. Regardless of the type of alopecia, changes in the dermis are manifested by the destruction of hair follicles followed by the presence of lymphohistiocytic infiltrates in the papillary and reticular dermis, as well as sclerosis of the papillary dermis. Discussion. It can be anticipated that the presence of lymphohistiocytic infiltrates in the papillary and reticular dermis may indicate the inflammatory process, which is accompanied by abnormal microcirculation and the destruction of the hair follicle which in turn insufficiently stimulates angiogenesis.