Pseudopelade Research Articles

A multiparametric approach is essential to define different clinicopathological entities within pseudopelade of Brocq: reply from authors

British Journal of DermatologyVolume 148, Issue 6 p. 1271-1272 A multiparametric approach is essential to define different clinicopathological entities within pseudopelade of Brocq: reply from authors L. Amato, L. Amato II Dermatology Clinic, Department of Dermatological Sciences, University of Florence, Via della Pergola 60, 50121 Firenze, ItalySearch for more papers by this authorS. Moretti, S. Moretti II Dermatology Clinic, Department of Dermatological Sciences, University of Florence, Via della Pergola 60, 50121 Firenze, ItalySearch for more papers by this authorP. Fabbri, P. Fabbri II Dermatology Clinic, Department of Dermatological Sciences, University of Florence, Via della Pergola 60, 50121 Firenze, ItalySearch for more papers by this author L. Amato, L. Amato II Dermatology Clinic, Department of Dermatological Sciences, University of Florence, Via della Pergola 60, 50121 Firenze, ItalySearch for more papers by this authorS. Moretti, S. Moretti II Dermatology Clinic, Department of Dermatological Sciences, University of Florence, Via della Pergola 60, 50121 Firenze, ItalySearch for more papers by this authorP. Fabbri, P. Fabbri II Dermatology Clinic, Department of Dermatological Sciences, University of Florence, Via della Pergola 60, 50121 Firenze, ItalySearch for more papers by this author First published: 27 June 2003 https://doi.org/10.1046/j.1365-2133.2003.05278.x Prof Paolo Fabbri. E-mail: Fabbri@unifi.it Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume148, Issue6June 2003Pages 1271-1272 RelatedInformation

Cicatricial alopecia; a dermatopathologic and immunopathologic study of 33 patients (pseudopelade of Brocq is not a specific clinico-pathologic entity).

Pseudopelade of Brocq (PB) is a permanent progressive scarring alopecia characterized by numerous alopecic patches localized only in the scalp, that tend to coalesce into larger, irregular plaques with policyclic borders. PB can be considered either the final atrophic stage of several scarring disorders such as lichen planus pilaris (LPP) and discoid lupus erythematosus (DLE) (secondary PB) or an autonomous disease (primary PB). The aim of this study was to assess the incidence of primary vs. secondary PB by a combined histopathological and immunopathological study in a series of patients who fulfilled the clinical diagnostic criteria for PB set forth by Braun Falco et al. We studied 33 patients (5 males and 28 females, whose age ranged from 24 to 75 years). The duration of the disease (from onset to biopsy) ranged from 3 months to 8 years. Serum samples were tested for circulating auto-antibodies (antinuclear antibodies anti ENA, anticentromere, anti-Scl70, antithyroid, antigastric parietal cells) circulating immune complexes, total and single fraction (C3, C4) complement activity. The skin biopsies taken from the active advancing margin of the more recent alopecic patch were bisected vertically, one was sent for histopathological examination, and the other for the immunofluorescence studies. In all patients the serum tests above were found to be negative or normal. Histopathologically, 11 biopsies (33.3%) displayed findings typical for LPP whereas seven cases (21.2%) showed typical DLE features. In the remaining 15 cases (45.5%) histopathological findings were not suggestive of any specific dermatosis. DIF investigations showed findings typical of LPP in six cases (18.1%) and typical of DLE in seven cases (21%). In three cases we did not find findings typical of LPP, DLE, or any other specific dermatitis. In 11 cases no immunological deposits could be detected and therefore were classified as negative. In conclusion, PB is a type of scarring alopecia of the scalp associated with a peculiar clinical presentation and evolution, which cannot be considered an autonomous nosologic entity because in 66.6% of patients it is the end stage of other inflammatory chronic diseases such as LPP and DLE. It is conceivable that even in those cases in which the histopathological and immunopathological findings did not allow for a specific diagnosis, LPP and DLE were also involved. It is noteworthy that in our study the histopathological and the immunopathological examinations did not conflict and often the results were even coincidental, thus confirming the compatibility of the combined histo-immunopathological approach in the diagnostic evaluation of PB.

Pseudopelade of Brocq in beard area

Pseudopelade is a rare self-limited hair disorder, resulting in cicatricial alopecia. It presents with skin-colored alopecic patches primarily involving the parietal and vertex portions of the scalp. This is a case report of a patient with pseudopelade that involves both his scalp and beard area. (J Am Acad Dermatol 2000;42:895-6.)

What is pseudopelade?

What is pseudopelade?

Pseudopelade of Brocq in a child

Pseudopelade of Brocq in a child

Pseudopelade of Brocq.

41 cases with scarring alopecia seen from 1979 to 1983 were analyzed and differentiated. After exclusion of 7 cases with lichen planopilaris, of 5 cases with discoid lupus erythematosus, of 2 cases with scleroderma, and of 1 case with folliculitis decalvans, there remained 26 cases. The clinical histological and direct immunofluorescence (DIF) findings in these patients suggest that pseudopelade of Brocq might be a distinct disease unrelated to other known types of scarring alopecia. The histopathology is characteristic, and shows the following features: little or only moderate lymphocytic infiltrate, absence of significant follicular plugging, and absence or decrease of sebaceous glands. DIF is negative, occasionally only IgM can be found at the basement membrane. The course of the disease is slowly progressive (in spite of little or no visible erythema), becoming eventually stationary after several years and resulting in a more or less severe permanent hair loss.

Circulatory Changes in Alopecia

The relationships between hair loss, hair growth, and vascular supply in the human scalp have not been precisely delineated. Alopecias from severe inflammatory processes which destroy the follicular unit have been fully documented. The combination of genetic susceptibility and androgenic inhibition of follicular growth in male and female patterned baldness is well recognized, but the role played by the vascular system is unknown. Little is understood concerning the pathogenesis of the mildly inflammatory alopecias, exemplified by alopecia areata, alopecia totalis, and pseudopelade of Brocq. Chronic diffuse thinning of the hair in women in the absence of known hereditary factors, while apparently becoming increasingly common, has not been satisfactorily explained. In a recent study, Kligman 1 has shown that temporary thinning of scalp hair following severe fevers, infections, pregnancy, and heparin administration is due to accelerated production of normal telogen hairs. The causative mechanisms in this group likewise remain obscure. This

Pseudopelade of Brocq: Its Relationship to Some Forms of Cicatricial Alopecias and to Lichen Planus

Pseudopelade of Brocq: Its Relationship to Some Forms of Cicatricial Alopecias and to Lichen Planus

Pseudo-Pelade of Brocq

Pseudo-Pelade of Brocq

Case of Macular Atrophy of the Scalp (Pseudo-Pelade of Brocq)

Case of Macular Atrophy of the Scalp (Pseudo-Pelade of Brocq)