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A Journal on Dermatology and Sexually Transmitted Diseases

Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2000 June;135(3):307-13


language: Italian

Is pseudopelade a specific disease entity? Pathogenetic correlation between pseudopelade and the other types of scarring alopecia resulting from a combined histopathological and immunopathological study

Amato L., Mei S., Massi D., Gallerani I., Fabbri P.

Università degli Studi - Firenze Dipartimento di Scienze Dermatologiche Clinica Dermatologica II * Istituto di Anatomia Patologica


Background. Aim of this paper is to study a group of patients with a clinico-morphological picture of pseudopelade. A combined histopathological and immunopathological (Direct immunofluorescence) research was carried out on a specimen taken from the border of an alopecic lesion of the scalp in order to get more information about this pathology and to distinguish a primary pseudopelade from those secondary to other diseases.
Methods. A total of 37 patients (8 males and 29 females, whose ages ranged from 24 to 87 years) with scarring alopecia presented in our Department over a 9 years period have been studied. These patients were diivded into two groups; in the first group there were 22 patients with pseudopelade (diagnosis was based on Braun Falco criteria) in the second, the case-control group, there were 15 patients with a not better defined type of scarring alopecia. Circulating autoantibodies, hepatitis B and C markers and routine examinations were evaluated in the serum, and a histopathological and immunopathological study (Direct Immunofluorescence: DIF) of a skin biopsy specimen taken from the border of a recent alopecic lesion was made in order to understand if these alopecic lesions could be considered primitive or secondary to Discoid Lupus Erythematosus (DLE), Lichen Planus Pilaris (LPP), scleroderma and cicatricial pemphigoid with well defined histopathological and immunopathological criteria.
Results. Serological findings were negative in both groups while combined histopathology and DIF showed that 59% patients with pseudopelade, and 66,6% patients with scarring alopecia of the control group presented the typical histopathological and immunopathological findings of DLE (8 patients with PA and 6 patients with AC), for LPP (8 patients with PA and none with AC).
Conclusions. The results obtained suggest that there isn’t a unique pathogenetic mechanism causing the clinico-morphological presentations of pseudopelade, in fact in about the 2/3 of the cases examined the sclero-atrophic evolution was the end stage of the same inflammatory diseases characteristics of the other types of scarring alopecia.

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