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. 2023 Jun 23;14(7):1326. doi: 10.3390/genes14071326

Table 3.

Summary table of key points for rapid differential diagnosis of common non-scarring alopecia.

Clinical Presentation Histopathological Findings Related Genes
FPHL
  • Widening of the central part line

  • Preservation of the hairline shape

  • Miniaturization of hair follicles

  • Increased hair shedding (not always present)

  • Increased number of miniaturized hair follicles, a terminal to vellus ratio (T/V ratio) usually less than 2:1

  • Reduced size of sebaceous glands

  • Decreased anagen to telogen ratio

  • Increased number of follicular stelae

  • Perifollicular inflammation around the upper portion of the hair follicle with or without perifollicular fibrosis

CYP19A1
ESR2
M-AGA
  • Gradual hair thinning in a distinct pattern (typically at the temples and crown)

  • Miniaturization of hair follicles leading to finer, shorter hairs

  • Increased hair shedding, especially during washing or brushing

AR
MC4R
EDA2R
SRD5A1
SRD5A2
[2,47]
Alopecia areata
  • Patchy hair loss in round or oval-shaped areas

  • Hair loss can progress to involve the entire scalp (alopecia totalis) or the entire body (alopecia universalis)

  1. “Swarm of Bees” pattern

  2. Peribulbar lymphocytic inflammation

  3. Catagen/telogen arrest

  4. Follicular miniaturization

  5. Exclamation mark hairs

  6. Dystrophic anagen hairs

NOTCH4
C6orf10
BTNL2
HLA-DRA
HLA-A
IL-2
IL2RA
STX17
TNXB
[71,72]
Chronic Telogen effluvium
  • Excessive shedding of telogen (resting) hairs for more than six months

  • Generalized thinning of hair all over the scalp without visible bald patches or specific pattern

  • Hair regrowth usually occurs once the underlying cause is addressed

  • Increased number of telogen hairs

  • No peribulbar inflammation

  • Preserved follicular structure

  • Absence of miniaturization

Cdx1 VDR
Taq1 VDR
[73]