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3 mm vs 4mm punch biopsy
Hi,
I am new to Alopecia World. Three weeks before Christmas I noticed the sides of my head of my hair seemed very thin. This after a family member had been diagnosed with Androgenetic Alopecia. I started to read about it and realized the changing of the hair strand itself had been what I had been noticing for a while. Thinner, not as easy to style, thinner bangs. I personally had never even heard of the hair follicle thinning. After looking closely at my scalp in the mirror I noticed there were areas with thinning hair (more the temple and tapering down the sides). I made an appointment with my dermatologist and went last Friday Jan 3rd. I was very disappointed with how it went. She obviously has had very little experience in this area. She did look through my hair and said we could run a biopsy at some point. She said, that their is some pinkness on my scalp and that I do not have the typical pattern of female pattern baldness. I said, yes I would like to do a biopsy, I would just like to know. My scalp has been itching and about 8 years ago I was diagnosed with oral Lichen Planus. She said, we will do a 3 punch. I have to say I did not even know what that meant. After coming home and looking it up, she did a 3mm punch biopsy. Everything I read says it should be a minimum of 4mm to get a firm diagnoses.
I am also waiting for blood work results.
She did not do a pull test or even suggest anything for the itching. The only thing she told me to use was minoxidil. I asked her about Laser Light therapy, but again minoxidil is the only thing that will help.
Has anyone else had a 3mm biopsy and been able to get the information needed for a proper diagnoses?
Thank you, Lilla
Replies to This Discussion
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Permalink Reply by Debs on
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From the description you have given you may have frontal fibrosing alopecia, this is what I have it is a varient of lichen Planopilaris and affects the front hairline, temples and sides. MAny derms are not well informed about this condition please do ask her to consider this as a diagnosis when the scalp biopsy is done, please see the group on this website for frontal fibrosing alopecia. Good luck with everything.
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Permalink Reply by Lilla on
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Debs, thank you for responding. Thank you for pointing me towards the group. I will check it out.
On Thursday 1/9 the dermatologist called me with the results of the biopsy. She told me it was Androgenetic Alopecia. I questioned her exstensively. I asked if it were any other alopecia would they have found it? Would they have tested for all types? She said, yes. I asked for a copy of the results, which she did e-mail me. I think she asked for them to look for two things. It says, DDX includes androgenetic Alopecia vs lichen planopilaris. Lab wrote, consistent with Androgenetic Alopecia. Shows miniaturized hair follicles with no evidence of scarring or significant inflammation. No fungi are detected. No evidence of lichen planopilaris is seen. Do you think they would have picked up the frontal fibrosing alopecia or would they have to look for it specifically? I have no doubt my hair strands have thinned throughout my whole head but my sides have areas where the hair is gone. like a thick part, but only on the sides. More in the temporal area. I feel I have caught whatever it is early and possibly the back will go too :) I know during my visit she said, it looked more like male pattern loss, which she said, was also possible. I have felt that a 2nd opinion may be in order. I am still waiting on the blood work to come back from my primary. I could then take all my paperwork to someone who is more knowledgeable. Do you have any suggestions of where to begin for a true diagnoses? Possibly, another dermatologist or a hair loss specialist?
Thank you!
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