毛发活检病理中国专家共识（2026版）

doi:10.35541/cjd.20250580

Abstract

Abstract: 【Abstract】 Hair disorders encompass a wide variety of hair conditions with diverse clinical manifestations. Hair pathology serves as a crucial, and in some cases indispensable, method for the precise diagnosis of certain hair disorders, particularly scarring alopecia and complex conditions. The Hair Disease Rehabilitation Group, Chinese Association of Rehabilitation Dermatology, the Hair Medicine Branch, Beijing Association of Holistic Integrative Medicine, the Hair Research Group, Chinese Society of Dermatology, and the National Clinical Research Center for Dermatologic and Immunologic Diseases organized a panel of Chinese clinical and pathological experts in hair disorders to formulate the "Chinese expert consensus on hair biopsy and pathology （2026 edition）". This consensus systematically elaborates on the indications of, technical procedures of, and pathological assessment standards for hair biopsy, and proposes strategies for dermoscopic-assisted sampling localization and specimen processing, aiming to enhance diagnostic consistency in hair diseases through standardized operational procedures and provide practical guidance for precise clinical-pathological diagnosis and treatment.

Key words: Alopecia, Biopsy, Dermoscopy, Therapeutics, Practice guideline as topic, Expert consensus, Hair pathology, Punch biopsy, Modified HoVert method

CLC Number:

Hair Disease Rehabilitation Group, Chinese Association of Rehabilitation Dermatology, Hair Medicine Branch, Beijing Association of Holistic Integrative Medicine, Hair Research Group, Chinese Society of Dermatology, National Clinical Research Center for Dermatologic and Immunologic Diseases. Chinese expert consensus on hair biopsy and pathology （2026 edition）[J]. Chinese Journal of Dermatology,2026,e20250580. doi:10.35541/cjd.20250580

References ［30］

［1］	Cummins DM, Chaudhry IH, Harries M. Scarring alopecias: pathology and an update on digital developments［J］. Biomedicines, 2021,9（12）:1755. DOI: 10.3390/biomedicines9121755.
［2］	Katoulis AC, Pappa G, Sgouros D, et al. A three⁃step diagnostic algorithm for alopecia: pattern analysis in trichoscopy［J］. J Clin Med, 2025,14（4）:1195. DOI: 10.3390/jcm14041195.
［3］	Sperling LC. The role of the scalp biopsy in the evaluation of alopecia［J］. J Am Acad Dermatol, 2023,89（2）:S16⁃S19. DOI: 10.1016/j.jaad.2023.05.047.
［4］	赵莹, 巩毓刚, 张斌, 等. 斑秃患者的临床特征 ⁃ 附524例临床、皮肤镜及病理特点［J］. 中国麻风皮肤病杂志, 2011,27（11）:751⁃754. DOI: 10.3969/j.issn.1009⁃1157.2011.11.002.
［5］	杜旭峰, 许文嵘, 李中明, 等. 脱发性疾病病理活检及切片技术方法学研究进展［J］. 临床皮肤科杂志, 2015,44（11）:750⁃755. DOI: 10.16761/j.cnki.1000⁃4963.2015.11.036.
［6］	Macías APA, Morales CCA, Balaguera OV. Biopsia de cuero cabelludo con sacabocados para el diagnóstico de las alopecias［J］. Dermatol Cosmet Med Quir, 2023,21（1）:7⁃12.
［7］	Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations［M］. 2nd ed. London: CRC Press, 2012. DOI: 10.3109/9781841847344.
［8］	Piraccini BM. Evaluation of hair loss［M］// Ioannides D, Tosti A. Alopecias - Practical Evaluation and Management. Basel:S.Karger AG, 2015. DOI: 10.1159/000369398.
［9］	Miteva M, Tosti A. Dermoscopy guided scalp biopsy in cicatricial alopecia［J］. J Eur Acad Dermatol Venereol, 2013,27（10）:1299⁃1303. DOI: 10.1111/j.1468⁃3083.2012.04530.x.
［10］	Fernández⁃Flores A, Cabo F. Histopathologic and trichoscopic correlations in nonscarring alopecias［J］. Actas Dermosifiliogr, 2023,114（6）:T502⁃T511. DOI: 10.1016/j.ad.2023.05.014.
［11］	胡瑞铭, 徐峰, 盛友渔, 等. 雄激素性秃发的皮肤镜特点及其与临床的关系［J］. 中华皮肤科杂志, 2014,47（9）:642⁃645.
［12］	Pirméz R. The dermatoscope in the hair clinic: trichoscopy of scarring and nonscarring alopecia［J］. J Am Acad Dermatol, 2023,89（2）:S9⁃S15. DOI: 10.1016/j.jaad.2023.04.033.
［13］	Kamyab⁃Hesari K, Aghazadeh N, Nourmohammadi⁃Pour P, et al. Diagnostic accuracy measures for vertical and transverse scalp biopsies in cicatricial and non⁃cicatricial alopecias［J］. Dermatol Sin, 2018,36（1）:30⁃35. DOI: 10.1016/j.dsi.2017.08.008.
［14］	李中明, 周南, 杜旭峰, 等. 头皮病理活检在脱发疾病诊疗中的相关应用［J］. 中华皮肤科杂志, 2019,52（1）:67⁃70. DOI: 10.3760/cma.j.issn.0412⁃4030.2019.01.022.
［15］	Zaiac MN, Bloom R, Morrison BW, et al. The figure 8: a new hair biopsy technique［J］. J Am Acad Dermatol, 2014,71（5）:e201. DOI: 10.1016/j.jaad.2014.04.047.
［16］	Hansen LM, Wu DJ, Liu D, et al. Gelatin foam instead of suturing for punch biopsies on the scalp［J］. J Am Acad Dermatol, 2021,84（1）:e15⁃e16. DOI: 10.1016/j.jaad.2020. 07.083.
［17］	Elston DM, McCollough ML, Angeloni VL. Vertical and transverse sections of alopecia biopsy specimens: combining the two to maximize diagnostic yield［J］. J Am Acad Dermatol, 1995,32（3）:454⁃457. DOI: 10.1016/0190⁃9622（95）90068⁃3.
［18］	Rubin AI, Seykora JT. Is more hair always better? A single biopsy specimen is preferred for the evaluation of alopecia［J］. J Cutan Pathol, 2013,41（1）:66⁃67. DOI: 10.1111/cup.12228.
［19］	Sinclair R, Jolley D, Mallari R, et al. The reliability of horizontally sectioned scalp biopsies in the diagnosis of chronic diffuse telogen hair loss in women［J］. J Am Acad Dermatol, 2004,51（2）:189⁃199. DOI: 10.1016/s0190⁃9622（03）00045⁃8.
［20］	Stefanato CM. Histopathology of alopecia: a clinicopathological approach to diagnosis［J］. Histopathology, 2009,56（1）:24⁃38. DOI: 10.1111/j.1365⁃2559.2009.03439.x.
［21］	Nguyen JV, Hudacek K, Whitten JA, et al. The HoVert technique: a novel method for the sectioning of alopecia biopsies［J］. J Cutan Pathol, 2011,38（5）:401⁃406. DOI: 10.1111/j.1600⁃0560.2010.01669.x.
［22］	Elston D. The 'Tyler technique' for alopecia biopsies［J］. J Cutan Pathol, 2012,39（2）:306⁃306. DOI: 10.1111/j.1600⁃0560. 2011.01839.x.
［23］	Tailor A, Asher RG, Craig PJ, et al. The current state of play in the histopathologic assessment of alopecia: two for one or one for two?［J］. J Cutan Pathol, 2013,40（3）:298⁃304. DOI: 10.1111/cup.12075.
［24］	Du X, Li Z, Xu W, et al. Diagnostic value of horizontal versus vertical sections for scarring and non⁃scarring alopecia: a systematic review and meta⁃analysis［J］. Eur J Dermatol, 2016,26（4）:361⁃369. DOI: 10.1684/ejd.2016.2797.
［25］	李中明, 许文嵘, 李煜乾, 等. 改良的 Ho⁃Vert 法切片对 21 例经典型毛发扁平苔藓临床病理诊断价值的观察［J］. 中华皮肤科杂志, 2020,53（1）:17⁃22. DOI: 10.35541/cjd.20190755.
［26］	Miteva M. Hair pathology with trichoscopic correlations ［M］. Boca Raton: CRC Press, 2021. DOI: 10.1201/9780429457609.
［27］	Pinedo⁃Moraleda F, Tristán⁃Martín B, Dradi GG. Alopecias: practical tips for the management of biopsies and main diagnostic clues for general pathologists and dermatopathologists［J］. J Clin Med, 2023,12（15）:5004. DOI: 10.3390/jcm12155004.
［28］	中华医学会皮肤性病学分会毛发学组. 毛发扁平苔藓/前额纤维化性秃发诊疗中国专家共识（2025版）［J］. 中华皮肤科杂志, 2025,58（7）:583⁃590. DOI: 10.35541/cjd.20250092.
［29］	李中明, 许文嵘, 朱麒麟, 等. 雄秃样纤维性秃发一例［J］. 中华皮肤科杂志, 2020,53（5）:356⁃359. DOI: 10.35541/cjd.2019 1142.
［30］	朱晶, 朱麒麟, 李中明, 等. 常见秃发的临床病理及毛发镜改变［J］. 武汉大学学报（医学版）, 2023,44（1）:1⁃9. DOI: 10. 14188/j.1671⁃8852.2022.0535.

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Chinese expert consensus on hair biopsy and pathology （2026 edition）

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