Affiliation:
1. Royal Free Hospital London UK
2. Current institution: University Hospitals of Southampton Southampton UK
3. Current institution: St George's University Hospitals Foundation Trust London UK
Abstract
AbstractBackgroundAccess to vertical and transverse sections of a punch biopsy specimen improves the diagnosis of alopecia. Both two biopsy specimen and single‐punch biopsy specimen techniques to visualize both transverse and vertical sections have been described. Their comparative diagnostic certainty is not known. We aimed to assess the diagnostic certainty of a modified HoVert (mHoVert) method, without direct immunofluorescence (DIF), compared to the St John's protocol, a two‐biopsy technique with DIF.MethodsFifty‐seven cases of alopecia processed using the St John's protocol and 60 cases of alopecia processed using mHoVert were reviewed. Diagnoses made were rated as certain/probable, possible, or uncertain, depending on the language in the histopathology report. Cases processed by the St John's protocol had final diagnosis and DIF result recorded.ResultsIn the mHoVert group, significantly more diagnoses were certain/probable (66%, 95% confidence interval [CI]: 57%–75%), compared to 46% (95% CI: 36%–56%) of diagnoses in the St John's protocol group (p = 0.005). DIF result did not affect the final diagnosis in any of the 57 cases reviewed.ConclusionsDIF is not required in the diagnosis of most cases of alopecia. The mHoVert method provides more certain/probable diagnoses than the St John's protocol and can reduce cost and patient morbidity.
Subject
Dermatology,Histology,Pathology and Forensic Medicine
Cited by
1 articles.
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