1. SIZE OF THE BIOPSY SHOULD 4 mm.
A
punch diagnostic test is ideal and will be four millimetre in size, suggested
by the best
hair transplant surgeon in kolkata . Too often smaller punches (3 or a
pair of mm) are used in plan to limit scars for the patient. while this can be
an honest thought, smaller biopsied provided limited info.
2. THE SPECIALIST SHOULD TOUCH UPON
THE DEPTH OF THE BIOPSY.
Ideally,
it’s nice to see that the diagnostic test goes deep enough into the scalp so
the pathologist features a smart chance to check what’s happening at the very
bottom of the hair follicles and even into the fat. Conditions like alopecia
areata and lots of response and inflammatory conditions and scarring alopecias
(dissecting cellulitis) go quite deep. A biopsy should be deep enough to
capture. this.
Many
biopsies aren't deep enough. Sometimes, there’s simply an excessive amount of
injury throughout the biopsy and a physician is afraid to go deeper. typically
the punch technique the physician is using isn't adequate and therefore the
punch is just not pushed deep enough once taking the sample.
3. HORIZONTAL SECTIONING OF THE
BIOPSY SAMPLE WAS CONSIDERED.
A
biopsy specimen will be cut side to side (horizontal sections) or up and down
(vertical sections). several labs nowadays can do both. It’s nice to possess
horizontal sections as this offers the pathologist a great deal of information
on 12-30 hair follicles. Vertical sections provide info on 3-7 hair follicles.
I prefer to highly to|favor to|opt to|choose to} work with a diagnostician
United Nations agency reads horizontal sections because it offers a great deal
more information. Most labs perform horizontal sections.
4. THE PATHOLOGIST COMMENTS ON THE
PROPORTION OF TERMINAL HAIRS, VELLUS HAIRS, ANAGEN HAIRS AND TELOGEN HAIRS IS
GIVEN.
If
horizontal sections are used to process the sample, it’s important to know
exactly what the pathologist sees. In this regard it’s nice to have information
about the proportion of terminal hairs, vellus hairs, anagen hairs and telogen
hairs in the biopsy.
1) A
high proportion of vellus hairs relative to terminal hairs given a clue to
possible androgenetic alopecia. Horizontal sections allow the pathologist to
comment on the ratio of terminal hairs to vellus hairs - which is a wonderful
clue for diagnosing androgenetic alopecia and in some cases also chronic
telogen effluvium. A terminal to vellus ratio less than 4:1 means androgenetic
alopecia in most cases and a T:V ratio above 8:1 signifies chronic TE.
2) A
high proportion of telogen hairs may also offer information about possible
underlying telogen effluvium. For example, normally there are less than 12 %
telogen hairs in a biopsy. As the percent of telogen hairs rises above 12-15 %
one must also wonder if a telogen effluvium is present. The diagnosis of
telogen effluvium is more of a clinical diagnosis than a pathology diagnosis.
So, even if the percentage of telogen hairs is less than 12 %, it’s still
possible that a patient has a telogen effluvium.
5. THE PATHOLOGIST COMMENTS ON THE
SEBACEOUS GLAND (OIL GLAND) DENSITY.
When
I scan a report, i would like to understand what’s happening to the oily glands
(oil glands). I definitely do wish to understand what’s happening to the hair
follicles (see below), but I’d wish to understand if the oily glands are
present, if they seem larger within the biopsy or if they're reduced. Reduction
in the density of oily glands is incredibly much a feature of scarring
alopecias. A relative increase in the look of oily glands may be a feature of
the many non scarring baldness like androgenetic alopecia, reported by the best
hair transplant surgeon in kolkata.