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J Dermatol. 2013 Dec;40(12):1045-8. doi: 10.1111/1346-8138.12350. Epub 2013 Dec 4.

Morphological changes of the hair roots in alopecia areata: a scanning electron microscopic study.

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  • 1Department of Dermatology, Kurume University School of Medicine, Kurume University Institute of Cutaneous Cell Biology, Kurume, Japan.


Alopecia areata is a chronic inflammatory condition causing non-scarring patchy hair loss. Diagnosis of alopecia areata is made by clinical observations, hair pluck test and dermoscopic signs. However, because differentiation from other alopecia diseases is occasionally difficult, an invasive diagnostic method using a punch biopsy is performed. In this study, to develop a reliable, less invasive diagnostic method for alopecia areata, we performed scanning electron microscopy of the hair roots of alopecia areata patients. This study identified four patterns of hair morphology specific to alopecia areata: (I) long tapering structure with no accumulation of scales; (II) club-shaped hair root with fine scales; (III) proximal accumulation of scales; and (IV) sharp tapering of the proximal end of hair. On the basis of these results, we can distinguish alopecia areata by scanning electron microscopic observation of the proximal end of the hair shafts.

© 2013 Japanese Dermatological Association.


alopecia areata; anagen; proximal end of the hair shaft; rhodamine; scanning electron microscopy

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