Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Brocq Pseudopelade Workup

  • Author: Kendall M Egan, MD, FAAD; Chief Editor: William D James, MD  more...
 
Updated: Oct 30, 2015
 

Laboratory Studies

Other than scalp biopsy, no laboratory test has been found useful in establishing the diagnosis of pseudopelade of Brocq. If the history or physical examination findings suggest evidence of lupus erythematosus, antinuclear antibody testing would be appropriate.

Next

Procedures

Scalp biopsy

Two 4-mm punch biopsy specimens should be obtained from an orientation along the direction of the hair follicle. Specimens should ideally be taken from a clinically well-established but active area of alopecia to include both normal and affected hair-bearing areas. One punch biopsy specimen should be submitted for horizontal sectioning and one for vertical sections if possible, both stained with hematoxylin and eosin and elastic tissue stains. The second punch biopsy specimen can be bisected vertically to accommodate both direct immunofluorescence (DIF) and hematoxylin and eosin staining.[7]

Previous
Next

Histologic Findings

The histopathologic criteria established by Pinkus were not correlated in any way with the clinical features.[17] Thus, pseudopelade as described by Pinkus is a histologic and not a clinical entity. In secondary pseudopelade, the histologic findings are those of a burnt-out scarring alopecia with absent hair follicles and fibrosis. Elastic tissue is absent in scarred areas. Idiopathic pseudopelade is characterized by a contracted dermis with dense collagen and loss of space between collagen bundles. Elastic fibers are recoiled and appear thick. Broad fibrous tract remnants are noted with preservation of the elastic sheath.

Previous
 
 
Contributor Information and Disclosures
Author

Kendall M Egan, MD, FAAD Dermatologist, Veteran's Affairs Medical Center; Dermatologist, Spruce Health, Dermatologist, DermOne

Kendall M Egan, MD, FAAD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists

Disclosure: Nothing to disclose.

Coauthor(s)

Kimberly L Maino, MD Mohs Surgeon and Dermatologist, Aurora Skin Care Center

Kimberly L Maino, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Medical Association, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Leonard Sperling, MD, to the development and writing of this article.

References
  1. Brocq L. Les folliculites et perifolliculites decalvantes. Bull Mem Soc Med Hop Paris. 1888. 5:339-408.

  2. Alzolibani AA, Kang H, Otberg N, Shapiro J. Pseudopelade of Brocq. Dermatol Ther. 2008 Jul-Aug. 21(4):257-63. [Medline].

  3. Braun-Falco O, Plewig G, Wolff H, Burgdorf W, eds. Diseases of Hair. Dermatology. 2nd ed. New York, NY: Springer-Verlag; 2000. 1120-21.

  4. Sperling LC. Brocq's alopecia (pseudopelade of Brocq) and "burnt out" scarring alopecia. Sperling LC, ed. An Atlas of Hair Pathology: With Clinical Correlations. London, England: Parthenon; 2003. 115-8.

  5. Bolognia J, Jorizzo J, Rapini R. Alopecias. Dermatology. 2nd ed. Spain: Elsevier; 2008. 1000.

  6. Sellheyer K, Bergfeld WF. Histopathologic evaluation of alopecias. Am J Dermatopathol. 2006 Jun. 28(3):236-59. [Medline].

  7. Otberg N, Wu WY, McElwee KJ, Shapiro J. Diagnosis and management of primary cicatricial alopecia: part I. Skinmed. 2008 Jan-Feb. 7(1):19-26. [Medline].

  8. Bulengo-Ransby SM, Headington JT. Pseudopelade of Brocq in a child. J Am Acad Dermatol. 1990 Nov. 23(5 Pt 1):944-5. [Medline].

  9. Collier PM, James MP. Pseudopelade of Brocq occurring in two brothers in childhood. Clin Exp Dermatol. 1994 Jan. 19(1):61-4. [Medline].

  10. Sperling LC, Solomon AR, Whiting DA. A new look at scarring alopecia. Arch Dermatol. 2000 Feb. 136(2):235-42. [Medline].

  11. Sperling LC, Cowper SE. The histopathology of primary cicatricial alopecia. Semin Cutan Med Surg. 2006 Mar. 25(1):41-50. [Medline].

  12. Rakowska A, Slowinska M, Kowalska-Oledzka E, Warszawik O, Czuwara J, Olszewska M, et al. Trichoscopy of cicatricial alopecia. J Drugs Dermatol. 2012 Jun. 11(6):753-8. [Medline].

  13. Madani S, Trotter MJ, Shapiro J. Pseudopelade of Brocq in beard area. J Am Acad Dermatol. 2000 May. 42(5 Pt 2):895-6. [Medline].

  14. Khong JJ, Casson RJ, Huilgol SC, Selva D. Madarosis. Surv Ophthalmol. 2006 Nov-Dec. 51(6):550-60. [Medline].

  15. Nikam VV, Mehta HH. A nonrandomized study of trichoscopy patterns using nonpolarized (contact) and polarized (noncontact) dermatoscopy in hair and shaft disorders. Int J Trichology. 2014 Apr. 6 (2):54-62. [Medline]. [Full Text].

  16. Sahl WJ. Pseudopelade: an inherited alopecia. Int J Dermatol. 1996 Oct. 35(10):715-9. [Medline].

  17. Pinkus H. Differential patterns of elastic fibers in scarring and non-scarring alopecias. J Cutan Pathol. 1978 Jun. 5(3):93-104. [Medline].

  18. Bergner T, Braun-Falco O. Pseudopelade of Brocq. J Am Acad Dermatol. 1991 Nov. 25(5 Pt 1):865-6. [Medline].

  19. Unger W, Unger R, Wesley C. The surgical treatment of cicatricial alopecia. Dermatol Ther. 2008 Jul-Aug. 21(4):295-311. [Medline].

Previous
Next
 
Irregularly shaped patch of scarring alopecia on the occiput of a middle-aged white woman. This asymptomatic lesion was first discovered by the patient's hairdresser.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.