Presented at the 2000 APIII Conference                        Return to 2000 Abstract Index

SPLITTING HAIRS: THE HISTOPATHOLOGICAL EVALUATION OF ALOPECIA

University of California, San Francisco
Department of Dermatopathology
San Francisco, California
Shawn E. Cowper, MD

Background: Alopecia, or hair loss, is a source of much consternation to patients and clinicians alike. To patients, hair loss can be psychologically devastating and sometimes a marker of serious systemic disease. To dermatologists, there is often enough ambiguity in the clinical presentation of alopecias to make a scalp biopsy a helpful, if not necessary, component of the clinical workup. Most pathologists, however, have not been specifically trained in the histopathological evaluation of scalp biopsies, and find themselves ill-equipped to make recommendations to the clinician regarding the appropriate submission and collection of samples.

Design: "Splitting Hairs: The histopathological evaluation of alopecias" began as a Dermatology Grand Rounds topic at the University of California, San Francisco. The presentation took the form of a projected frames-based HTML teaching session/lecture. The format allowed for internal linking as well as a virtual examination of hair follicle anatomy using image mapping. The popularity of the presentation prompted the development of a Web site which endeavors to educate clinicians and pathologists in the following areas:

  1. Collection of scalp biopsy specimen(s)
  2. Histopathological changes of cycling human hair
  3. A comparison of vertical and horizontal hair anatomy
  4. A focused clinico-pathologic study set of many of the most commonly encountered diagnoses
  5. An integrated glossary and reference section.

Results: The results of such a project are concretely measured by the use of the site (number of hits). The true benefit of the site, however, is the enlightenment and enjoyment of the users, as well as the benefits of an improved understanding of alopecias and their histopathological appearance. If the response of attendees to the preliminary presentation in San Francisco is representative, the website should be well-received.

Conclusion: "Splitting Hairs" will be hosted on PathMax (http://www.pathmax.com) and is projected to be a web-based locus for the study of the biopsy evaluation of alopecia. It will serve as a framework upon which additional diagnoses and a tutorial will be added in the future, and will hopefully serve as a model for additional web-based projects in the field of dermatopathology.