Indian Journal of Dermatology
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Year : 2022  |  Volume : 67  |  Issue : 4  |  Page : 324-327

Clinico-pathological concordance rate of scalp lesions showing alopecia

From the Department of Dermatology, College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, Korea

Correspondence Address:
Eun Joo Park
22 Gwanpyeong-ro 170beon-gil Dongan-gu, Anyang-si Gyeonggi-do
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijd.ijd_112_22

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Background: Some alopecic diseases can be diagnosed by detailed history taking and physical examination, but in many cases, biopsy must be performed to make a definite diagnosis. Aims and Objectives: This study aimed to evaluate the clinico-pathological concordance of scalp lesions showing alopecia. Materials and Methods: We retrospectively reviewed the electronic medical records and biopsy slides of patients who underwent biopsy for evaluating scalp lesions showing alopecia. Based on the definitions of clinico-pathological concordances, scalp alopecic disease was evaluated. Results: A total of 121 patients were enrolled in the study. A total of 203 clinical differential diagnoses were made before performing a biopsy. Thirty-one patients showed full concordance, and 58 patients showed partial concordance; thus overall concordance was shown in 89 patients (73.55%). Folliculitis decalvans and alopecia areata showed a higher full concordance rate than average (P < 0.05), whereas dissecting folliculitis showed a lower overall concordance rate than average, and folliculitis decalvans showed a higher overall concordance rate than average (P < 0.05). The overall concordance rate of alopecia areata was 100% (P = 0.061). Conclusion: In diagnosing folliculitis decalvans and alopecia areata, which showed high full and overall concordance, performing a biopsy to make a definite diagnosis is not always necessary, especially when patients show typical clinical features. Dissecting folliculitis, which showed low overall concordance, was less likely to be suspected as a clinical differential diagnosis, making it difficult to distinguish based on clinical findings alone. Therefore, when it is suspected, a detailed evaluation including a biopsy is recommended.

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