title: Direct immunofluorescence pattern and histopathological staging in alopecia areata.
abstract: OBJECTIVE
  The present study was designed to categorize alopecia areata (AA) into various stages based on histopathology and further study the direct immunofluorescence (DIF) pattern.
  
  
  METHODS
  The current study is noninterventional, prospective study on 25 consecutive patients suspected of AA based on clinical assessment. Histomorphologic features and immunoreactivity for IgG, IgM, IgA, and C3, was studied on biopsy material.
  
  
  RESULTS
  Age of the patients ranged from 6 years to 48 years with a mean age of 28.56 ± 21.8 years. Majority of patients, 9 (36%) were in the age group of 21-30 years. Of 25 patients, 13 (52%) were males and 12 (48%) were females. Male: female ratio was 1.1:1. On histopathology majority of cases were in subacute stage 9 (36%), followed by chronic 7 (28%), acute 5 (20%) and recovery stages 4 (16%). Three (12%) of 4 cases showed characteristic swarm of bees appearance. Two (8%) of the cases showed presence of giant cells. Increased numbers of catagen hair were seen in 12 (48%) cases. Of 25 cases, 9 (36%) cases showed positive DIF with granular deposits. The most common immunoreactant was IgG in 7 (28%) cases, followed by IgA in 4 (16%), C3 in 6 (24%) and IgM in 3 (12%) cases. Of 9 cases showing positive staining, 3 (12%) were in acute stage and 2 (8%) each in subacute, chronic and recovery stages.
  
  
  CONCLUSIONS
  The observations further reiterate that immune mechanisms play a role in the pathogenesis of AA.
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh, India.
authors.forename: Sai
authors.initials: S
authors.lastname: Kulkarni
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh, India.
authors.forename: Rajpal Singh
authors.initials: RS
authors.lastname: Punia
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh, India.
authors.forename: Reetu
authors.initials: R
authors.lastname: Kundu
authors.affiliation: Department of Dermatology and Venereology, Government Medical College and Hospital, Sector 32-A, Chandigarh, India.
authors.forename: Gurvinder Pal
authors.initials: GP
authors.lastname: Thami
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh, India.
authors.forename: Harsh
authors.initials: H
authors.lastname: Mohan
keywords: Alopecia areata; antibody; hair; histopathology; immunofluorescence