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首页> 外文期刊>Journal of cutaneous pathology >Possible role of the bulge region in the pathogenesis of inflammatory scarring alopecia: lichen planopilaris as the prototype.
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Possible role of the bulge region in the pathogenesis of inflammatory scarring alopecia: lichen planopilaris as the prototype.

机译：凸起区域在炎性瘢痕性脱发的发病机理中的可能作用：以扁平苔藓为原型。

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BACKGROUND: Lichen planopilaris (LPP) is the prototype of scarring alopecias that mainly target the infundibuloisthmic (bulge) region of hair follicle. Hair follicle stem cells have been shown to reside in the bulge. METHODS: We carried out this study to better define the possible pathogenetic role of the bulge in LPP. Thirty-five cases of LPP were studied. Multiple serial sections of biopsy specimens stained with hematoxylin and eosin, periodic acid Schiff-diastase, and Elastic van Gieson. The following immunostains were applied: CD3, CD4, CD8, CD1a, and Ki-67. Uninvolved follicles and normal scalp biopsy specimens served as normal controls. RESULTS: All cases showed a lichenoid lymphocytic infiltrate at the bulge region. The bulb area was spared. CD8(+) T cells were increased compared with CD4(+) T-cell population. Langerhans' cells were decreased. Proliferating stem cells, highlighted by Ki-67, showed a marked decrease in the bulge compared with uninvolved follicles. CONCLUSION: Our study supports the finding that in LPP, the inflammatory infiltrate mainly involves the bulge region, where the stem cells reside. Once this area is damaged, the hair loses its potential of regrowth with resulting scarring alopecia. This is in contrast with inflammatory non-scarring alopecias such as alopecia areata, where the bulb region is targeted, sparing the stem cells.
机译：背景：扁平苔藓（LPP）是疤痕性脱发的原型，主要针对毛囊的漏斗鞘（隆起）区域。毛囊干细胞已显示存在于凸起中。方法：我们进行了这项研究，以更好地确定隆起在LPP中的可能的致病作用。研究了35例LPP病例。用苏木精和曙红，高碘酸席夫-舒张酶和弹性范吉森染色的活检标本的多个连续切片。应用了以下免疫染色：CD3，CD4，CD8，CD1a和Ki-67。正常卵泡和正​​常头皮活检标本作为对照。结果：所有病例均在隆起区出现苔藓样淋巴细胞浸润。灯泡区域不存在。与CD4（+）T细胞群体相比，CD8（+）T细胞增加。朗格汉斯细胞减少。与未感染的卵泡相比，以Ki-67突出的增殖干细胞显示出凸起的明显减少。结论：我们的研究支持以下发现：在LPP中，炎性浸润主要涉及干细胞所在的凸起区域。一旦该区域受损，头发就会失去长生的潜力，从而导致瘢痕性脱发。这与炎症性非疤痕性秃发（例如斑秃）相反，后者以球茎区域为目标，保留了干细胞。

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