Lymphocytic Mediated Alopecia: Histological Classification by Pattern Analysis
March 2001
in “
Clinics in Dermatology
”
lymphocyte-mediated alopecia peribulbar pattern infundibular and isthmus pattern panfollicular pattern stem cell pattern alopecia areata lichen planopilaris lupus erythematosus peribulbar lymphocytic inflammation follicle miniaturization scarring alopecia non-scarring alopecia lymphocytic alopecia alopecia areata lichen planopilaris lupus
TLDR Steven Kossard classified lymphocyte-related hair loss into four patterns, each linked to different types of baldness.
In 2001, Steven Kossard proposed a histological classification for lymphocyte-mediated alopecia, identifying four patterns of lymphocytic follicular inflammation: peribulbar, infundibular and isthmus, panfollicular, and stem cell. These patterns were associated with different clinical presentations of alopecia, such as diffuse, localized, patterned, and scarring or non-scarring types. The peribulbar pattern was linked to alopecia areata and featured peribulbar lymphocytic inflammation and follicle miniaturization. Lichen planopilaris was associated with the infundibular and isthmus pattern, characterized by inflammation and destruction of the upper part of the follicle. Lupus erythematosus showed a panfollicular pattern with lymphocytic targeting of the entire follicular unit. The classification aimed to improve diagnosis and understanding of the immunological mechanisms behind hair loss, with the anticipation of advancements from molecular pathology.
