10.5826/dpc.1302a88
text/xml
2160-9381
2661
en
Amalia Moreno-Torres
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Elastic Stain in Pseudopelade of Brocq: a Helpful Histopathological Diagnostic Clue 
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-04-29
2022-06-18
2023-04-29
2023-06-05
e2023088
Dermatol Pract Concept
Amalia Moreno-Torres
2023/04/29
10.5826/dpc.1302a88
e2023088
Pathology Department, Hospital Universitario de Fuenlabrada, Madrid
2160-9381
en
e2023088
Ramos-e-Silva M, Pirmez R. Disorders of hair growth and the pilosebaceous unit: Facts and controversies. Clin Dermatol. 2013;31(6):759-763. doi:10.1016/j.clindermatol.2013.06.003
Elastic Stain in Pseudopelade of Brocq: a Helpful Histopathological Diagnostic Clue 
https://dpcj.org/index.php/dpc/article/download/2661/2097
    Elastic Stain in Pseudopelade of Brocq: a Helpful
            Histopathological Diagnostic Clue
          Gloria Baeza-Hernández1, Mercedes Isabel Jaquero-Valero2, Ricardo Francisco
             Rubio-Aguilera1, Luis Carlos Araya-Umaña2, Celia Horcajada-Reales1,
                                    Amalia Moreno-Torres2


1 Dermatology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
2 Pathology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain



Citation: Baeza-Hernández G, Jaquero-Valero MI, Rubio-Aguilera RF, Araya-Umaña LC, Horcajada-Reales C, Moreno-Torres A.
Elastic Stain in Pseudopelade of Brocq: a Helpful Histopathological Diagnostic Clue. Dermatol Pract Concept. 2023;13(2):e2023088.
DOI: https://doi.org/10.5826/dpc.1302a88
Accepted: October 6, 2022; Published: April 2023
Copyright: ©2023 Baeza-Hernández et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Gloria Baeza-Hernández, Servicio de Dermatología Hospital de Fuenlabrada, Camino del Molino 2,
28942 Fuenlabrada, Madrid. E-mail: gloria.baeza@salud.madrid.org




Case Presentation                                                        of pseudopelade of Brocq was made with clinicopatholog-
                                                                         ical correlation: the patient had reduced hair density with
A 50-year-old Caucasian woman presented to the derma-                    a scarred background on the interparietal area, towards the
tology clinic complaining of hair loss over at least 5 years,            vertex, with no signs of inflammation.
without itching or redness. A 4 mm punch biopsy fixed in
10% buffered formalin was sent to our laboratory and then
                                                                         Teaching Point
vertically bisected for analysis (Figure 1). It showed features
of scarring alopecia, with a syringomatous proliferation in              Elastic stains like Verhoeff-van Giesson and orcein are
a fibrous zone; with orcein stain dense elastic fibers could             part of an alopecia histopathological routine study and
be observed within a fibrous tract that extended below and               can aid in the differential diagnosis of scarring alopecias.
above the insertion of the arrector pili muscle. The network             ­Elastic ­fibers are characteristically preserved and thickened
of elastic fibers in the dermis was preserved. A diagnosis               in central centrifugal cicatricial alopecia and pseudopelade




Image Letter | Dermatol Pract Concept. 2023;13(2):e2023088                                                                            1
    Figure 1. (A, B) Pseudopelade of Brocq: H-E x10 (A) and elastic stain-orcein x10 (B). The dermal elastic network is intact. Dense elastic
    fibers can be observed along a band of fibrous tissue which stretches below and above the preserved arrector pili muscle. Syringomatous
    hyperplasia can be observed (on the right).




of Brocq, while other types of scarring alopecias like lupus              References
­erythematosus or lichen planopilaris show loss or absence
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                                                                              2015;106(4):260-270. DOI:10.1016/j.ad.2014.06.016. PMID:
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still under debate, it being a diagnosis of exclusion, some                2. Ramos-e-Silva M, Pirmez R. Disorders of hair growth and the
recent molecular studies have begun to shed light in its dis-                 pilosebaceous unit: Facts and controversies. Clin Dermatol.
tinction from lichen planopilaris [1,2]. Further research is                  2013;31(6):759-763. DOI:10.1016/j.clindermatol.2013.06.003.
still needed to clear up this long-standing controversy.                      PMID: 24160282.




2                                                                                Image Letter | Dermatol Pract Concept. 2023;13(2):e2023088
