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Abstract：
BACKGROUND: Recently, polarized microscopy was reported as helpful in the evaluation of alopecia biopsy specimens.
OBJECTIVE: We sought to determine the usefulness of polarized microscopy relative to elastic tissue staining and fluorescent microscopy.
METHODS: Histologic sections from 60 alopecia specimens were evaluated to determine the pattern of elastic tissue in elastic van Gieson-stained sections. Comparable hematoxylin-eosin sections were examined under a fluorescent microscope to determine the elastic tissue pattern and examined under polarized microscopy to determine the pattern of birefringence.
RESULTS: Elastic van Gieson staining demonstrated high sensitivity (1.0) and high specificity (1.0) for the identification of nonscarring alopecia. In 54 of 60 cases, fluorescent microscopy demonstrated an identical pattern of elastic tissue. High background eosin fluorescence made it impossible to interpret the elastic tissue pattern in the remaining 6 specimens. Strong birefringence in dermal collagen sparing fibrous tracts had high specificity (1.0) but lower sensitivity (0.59). Strong collagen birefringence within the dermis and broad fibrous tracts were present in all 6 cases of central centrifugal cicatricial alopecia.
CONCLUSIONS: Elimination of the 6 uninterpretable specimens with high background fluorescence from our calculations may be a source of bias, as these cases could potentially all have been either negative or positive.
CONCLUSIONS: Elastic tissue staining is the most reliable means to determine the pattern of scarring in alopecia biopsy specimens. In most cases, fluorescent microscopy of hematoxylin-eosin sections shows an identical pattern. Although a pattern of collagen birefringence on polarized microscopy distinctly sparing fibrous tract is specific for nonscarring alopecia, not all cases of nonscarring alopecia demonstrate this pattern. Strong collagen birefringence within both the dermis and fibrous tracts suggests a diagnosis of central centrifugal cicatricial alopecia.
OBJECTIVE: We sought to determine the usefulness of polarized microscopy relative to elastic tissue staining and fluorescent microscopy.
METHODS: Histologic sections from 60 alopecia specimens were evaluated to determine the pattern of elastic tissue in elastic van Gieson-stained sections. Comparable hematoxylin-eosin sections were examined under a fluorescent microscope to determine the elastic tissue pattern and examined under polarized microscopy to determine the pattern of birefringence.
RESULTS: Elastic van Gieson staining demonstrated high sensitivity (1.0) and high specificity (1.0) for the identification of nonscarring alopecia. In 54 of 60 cases, fluorescent microscopy demonstrated an identical pattern of elastic tissue. High background eosin fluorescence made it impossible to interpret the elastic tissue pattern in the remaining 6 specimens. Strong birefringence in dermal collagen sparing fibrous tracts had high specificity (1.0) but lower sensitivity (0.59). Strong collagen birefringence within the dermis and broad fibrous tracts were present in all 6 cases of central centrifugal cicatricial alopecia.
CONCLUSIONS: Elimination of the 6 uninterpretable specimens with high background fluorescence from our calculations may be a source of bias, as these cases could potentially all have been either negative or positive.
CONCLUSIONS: Elastic tissue staining is the most reliable means to determine the pattern of scarring in alopecia biopsy specimens. In most cases, fluorescent microscopy of hematoxylin-eosin sections shows an identical pattern. Although a pattern of collagen birefringence on polarized microscopy distinctly sparing fibrous tract is specific for nonscarring alopecia, not all cases of nonscarring alopecia demonstrate this pattern. Strong collagen birefringence within both the dermis and fibrous tracts suggests a diagnosis of central centrifugal cicatricial alopecia.
摘要：
背景：最近，据报道，偏光显微镜有助于评估脱发活检标本。
目的：我们试图确定偏振显微镜相对于弹性组织染色和荧光显微镜的有用性。
方法：对60个脱发标本的组织切片进行了评估，以确定弹性范吉森染色切片中弹性组织的模式。在荧光显微镜下检查可比较的苏木精-伊红切片以确定弹性组织图案,并在偏振显微镜下检查以确定双折射图案。
结果：ElasticvanGieson染色显示出非瘢痕性脱发的高灵敏度（1.0）和高特异性（1.0）。在60个案例中，有54个荧光显微镜显示弹性组织的相同模式。高背景曙红荧光使得无法解释其余6个标本中的弹性组织模式。真皮胶原蛋白保留纤维束中的强双折射具有高特异性（1.0），但敏感性较低（0.59）。在所有6例中央离心瘢痕性脱发病例中，真皮内存在强烈的胶原蛋白双折射和宽阔的纤维束。
结论：从我们的计算中消除具有高背景荧光的6个不可解释的标本可能是偏差的来源，因为这些病例可能都是阴性或阳性。
结论：弹性组织染色是确定脱发活检标本中瘢痕形成模式的最可靠方法。在大多数情况下,苏木精-伊红切片的荧光显微镜显示相同的图案。尽管在偏振显微镜上明显保留纤维束的胶原蛋白双折射模式对非瘢痕性脱发具有特异性，并非所有非瘢痕性脱发病例都能证明这种模式。真皮和纤维束内强烈的胶原蛋白双折射表明诊断为中央离心瘢痕性脱发。
目的：我们试图确定偏振显微镜相对于弹性组织染色和荧光显微镜的有用性。
方法：对60个脱发标本的组织切片进行了评估，以确定弹性范吉森染色切片中弹性组织的模式。在荧光显微镜下检查可比较的苏木精-伊红切片以确定弹性组织图案,并在偏振显微镜下检查以确定双折射图案。
结果：ElasticvanGieson染色显示出非瘢痕性脱发的高灵敏度（1.0）和高特异性（1.0）。在60个案例中，有54个荧光显微镜显示弹性组织的相同模式。高背景曙红荧光使得无法解释其余6个标本中的弹性组织模式。真皮胶原蛋白保留纤维束中的强双折射具有高特异性（1.0），但敏感性较低（0.59）。在所有6例中央离心瘢痕性脱发病例中，真皮内存在强烈的胶原蛋白双折射和宽阔的纤维束。
结论：从我们的计算中消除具有高背景荧光的6个不可解释的标本可能是偏差的来源，因为这些病例可能都是阴性或阳性。
结论：弹性组织染色是确定脱发活检标本中瘢痕形成模式的最可靠方法。在大多数情况下,苏木精-伊红切片的荧光显微镜显示相同的图案。尽管在偏振显微镜上明显保留纤维束的胶原蛋白双折射模式对非瘢痕性脱发具有特异性，并非所有非瘢痕性脱发病例都能证明这种模式。真皮和纤维束内强烈的胶原蛋白双折射表明诊断为中央离心瘢痕性脱发。
