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Histopathological and immunohistochemical features of facial papules in frontal fibrosing alopecia
Author(s) -
Rakhshan A.,
Momenpour N.,
Dadkhahfar S.,
Gheisari M.
Publication year - 2021
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.14670
Subject(s) - vellus hair , pathology , medicine , fibrosis , dermis , biopsy , papule , histopathology , immunohistochemistry , dermatology , lesion , scalp
Summary Background Facial papules (FPs) are considered to be created by the inflammatory process, which involves facial vellus hairs, in frontal fibrosing alopecia. Aim To demonstrate the histopathological features of FPs and the composition of the inflammatory infiltrate. Methods In total, 18 patients with FPs were enrolled in the study after histopathological confirmation of lichen planopilaris. Histopathological evaluation of the specimens was performed by two dermatopathologists. The samples were immunostained with CD4, CD8 and CD123 monoclonal antibodies, and the percentage and proportion of cells stained with these markers were investigated. Results A follicular lichenoid reaction and perifollicular fibrosis were present in all cases. Vellus hairs were detected in 83.3% of biopsy specimens (15 cases), all of which were involved by the inflammation. The majority of the follicles (72%) revealed follicular plugs. Reduction and destruction of elastic fibres were visible in the perifollicular (adventitial) and the papillary dermis (100% and 78% of specimens, respectively). Prominent sebaceous glands and dilated ducts were detected in 78% and 72% of samples, respectively. CD4‐positive T cells formed 67.72% and CD8‐positive T cells 32.28% of the infiltrate, and the mean CD4/CD8 ratio was 2.48. In 13 (72.2%) biopsy specimens < 10% of the infiltrate was positive for CD123 marker. Conclusions Perifollicular inflammation, fibrosis and elastic‐fibre destruction were constant histopathological features of FPs; furthermore, prominent sebaceous glands were present in the majority of samples. We also observed a CD4‐positive predominance in the infiltrate.