Analysis of Clincial Histologic Correlations in Alopecia Areata and Telogen Effluvium: Adversities in Alopecia Pattern Mimicry

Alopecia is a clinical and histologic challenge. Much of the difficulty arises from the perceived obvious clinical presentation, coupled with few treatment options and/or poor therapeutic response. As a result of the seemingly obvious clinical nature of alopecia, biopsies rarely are performed. The goal of this study was to evaluate the role of biopsies in evaluation of patients with hair loss with differential diagnoses of alopecia areata and/or telogen effluvium.

Pattern mimics may be more prevalent than previously thought, and an alopecia pattern may not necessarily lead to a diagnosis, as some diagnoses may mimic several patterns. Overall, these mimics and overlap cases are a large percentage of difficult-to-manage clinical presentations of alopecia that result in biopsy. Further research is critically needed to advance the physician's diagnostic criteria and capability as well as management of these alopecia mimics in both clinical and histologic terms.