Abstract:

Objective To assess the microscopic features of alopecia areata （AA） by using in vivo confocal laser scanning microscopy （CLSM）. Methods Between January 2010 and May 2011, 26 male and 20 female patients diagnosed with AA were enrolled in this study. AA lesions and perilesional normal skin were examined by means of in vivo CLSM. Tissue specimens were obtained from the lesions and perilesional normal skin of 10 out of the 46 patients and subjected to routine histopathologic examination. Results The number of hair follicles per unit area （cm2） was decreased in lesions of progressive AA and resting AA compared with normal perilesional skin （134.856 ± 18.301 and 147.159 ± 17.536 vs. 301.613 ± 35.317, both P < 0.05）. Although the quantity of hair follicles increased in lesions of recovery AA （（227.778 ± 16.861）/cm2）, but was still less than that in the normal perilesional skin （P < 0.05）. There was a lack of hair shaft in follicles, as well as an inflammatory infiltration in hair follicles, around hair follicles and capillaries in superficial dermis in lesions of progressive AA. The inflammatory infiltration was attenuated in lesions of resting AA. In lesions of recovery AA, the infiltration was further attenuated with an apparent growth of lanugos and terminal hairs. Conclusions As far as AA lesions are concerned, CLSM images are consistent with histopathological findings. CLSM may serve as a promising tool for monitoring efficacy and predicting prognosis based on hair growth cycle, hair follicle number, and inflammatory infiltration degree.

Key words: Pathology, clinical