ABSTRACT
BACKGROUND: This study was performed to demonstrate the usefulness of horizontal and vertical
sections of scalp biopsies in diagnosing various forms of primary alopecias and to
highlight the importance of error-free grossing.
MATERIALS AND METHODS: A retrospective analytical review of 228 scalp biopsies was done, noting down the
diagnostic histopathological features evident in horizontal and vertical sections
of each cases. The idealness of the sections, especially horizontal section, was also
analyzed.
RESULTS: Out of the 228 cases, 44 scalp biopsies were classified histologically as cicatricial
alopecias and the remaining 162 as noncicatricial alopecia. 22 cases were inconclusive
owing to erroneous grossing. We found horizontal sections to be more useful in cases
of noncicatricial alopecias, whereas vertical sections proved superior in cicatricial
alopecias.
CONCLUSION: Combining both horizontally and vertically sectioned scalp biopsies maximizes the
diagnostic yield. When a single biopsy is submitted, the choice between horizontal
and vertical section should depend on clinical diagnosis/suspicion.
Key words
Cicatricial alopecia - horizontal section - noncicatricial alopecia - vertical section