CAN MY SCALP BIOPSY BE WRONG?

Can scalp biopsies be wrong?

I’ve selected this question below for this week’s question of the week. It allows us to review some concepts related to accuracy of scalp biopsies.

Question

My biopsy says that I have a non-scarring alopecia but I’m terrified that I actually have a scarring alopecia. Is it possible that my biopsy could be wrong?

Answer

Sure, it’s possible for a biopsy to be wrong but pretty unlikely in a scenario like this. Of course, I would need to see your scalp up close and know more about your story and then I could answer if you have a scarring alopecia or not.

Please note that it’s more common for a patient to receive a biopsy report saying they have scarring alopecia when they do not really have scarring alopecia than for a patient to receive a biopsy report suggesting they have non-scarring alopecia when they actually have a scarring alopecia. So, if there is going to be an error, it “usually” tends to go in the other direction.

But please keep in mind some key points. If you have scarring alopecia in the crown area of the scalp and your doctor took the biopsy somewhere else than the crown area …. well then a scarring alopecia probably won’t show up in that biopsy.

Lots of poeple worry they have scarring alopecia when they have a red scalp and/or an itchy scalp. Please don’t assume for one minute that the only thing that can cause redness, itching, burning, pain, shedding is scarring alopecia. Lots and lots of other conditions can too. If you are skeptical or doubtful just have another doctor review your biopsy or case. Another review of the biopsy can always be done or another repeat biopsy can be performed.