Miniaturization of sebaceous glands: A novel histopathological finding in pemphigus vulgaris and pemphigus foliaceus of the scalp

Sar‐Pomian, Marta; Czuwara, Joanna; Rudnicka, Lidia; Olszewska, Małgorzata

doi:10.1111/cup.12994

Cited by 10 publications

(15 citation statements)

References 26 publications

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“…reported acantholysis extending from the infundibulum to the suprabulbar region in anagen hair follicles in patients with PV and progressive hair loss . Our recent findings confirm that acantholysis is located along the outer root sheath of the hair follicle in patients with PV …”

Section: Discussionsupporting

confidence: 86%

“…4 Our recent findings confirm that acantholysis is located along the outer root sheath of the hair follicle in patients with PV. 14 Follicular acantholysis may be explained by the distribution of desmogleins in the structure of the hair follicle. 1 Dsg1 is expressed in the inner root sheath, in the innermost layers of the outer root sheath, and in epidermal suprabasal cells, 1 whereas expression of Dsg3 in the hair follicle depends on keratinization type.…”

Section: Discussionmentioning

confidence: 99%

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Increased risk of severe course of pemphigus in patients with pemphigus‐associated alopecia: a prospective observational study

et al. 2018

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Summary Background Pemphigus‐associated alopecia is considered rare, and has not been studied in detail. Aim To evaluate the clinical and immunological characteristics of patients with pemphigus‐associated alopecia. Methods This prospective observational study included 80 consecutive patients with histopathologically and immunopathologically confirmed pemphigus, of whom 11 (13.8%) were found to have pemphigus‐associated alopecia. Alopecia was observed in 11/52 patients with pemphigus and scalp involvement: [0/28 (35.7%) with pemphigus vulgaris and 1/24 (4.2%) with pemphigus foliaceus. The clinical and immunological characteristics of these patients were analysed. Results Patients with pemphigus‐associated alopecia had a significantly higher Pemphigus Disease Area Index total activity score compared with patients who had no pemphigus‐associated alopecia (21.8 ± 18.6 and 11.0 ± 20.5, respectively; P = 0.02). Mean serum anti‐desmoglein (Dsg)1 antibody concentration was 141.8 ± 66.9 U/mL and 60.0 ± 52.6 U/mL, respectively (P = 0.03), and mean serum anti‐Dsg3 concentration was 126.6 ± 36.7 U/mL and 67.4 ± 52.5 U/mL, respectively (P = 0.03). The values for achieving serological remission were 10% and 70%, respectively (P = 0.02). Conclusions Pemphigus‐associated alopecia is a marker of severe disease and a treatment‐resistant disease course.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Increased risk of severe course of pemphigus in patients with pemphigus‐associated alopecia: a prospective observational study

et al. 2018

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“…A case report of pemphigus foliaceus by Mlynek et al described acantholysis which was observed in the infundibular outer root sheath, sparing its infrainfundibular part [ 25 ]. In our recent study performed on 32 patients with pemphigus, we observed that follicular acantholysis is a common feature of both types of pemphigus occurring in 12/17 (70.6%) patients with pemphigus vulgaris and 12/15 (80.0%) patients with pemphigus foliaceus [ 42 ]. We also confirmed that pemphigus vulgaris and pemphigus foliaceus differ as regards the depth of acantholysis.…”

Section: Resultsmentioning

confidence: 99%

“…We also confirmed that pemphigus vulgaris and pemphigus foliaceus differ as regards the depth of acantholysis. Acantholysis extended down the entire length of the outer root sheath of the hair follicle in pemphigus vulgaris, whereas in pemphigus foliaceus acantholysis was restricted to the infundibulum [ 42 ]. Acantholysis was also observed in vellus hair follicles in 12/17 (70.6%) patients with pemphigus vulgaris and 9/15 (60.0%) patients with pemphigus foliaceus [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Acantholysis extended down the entire length of the outer root sheath of the hair follicle in pemphigus vulgaris, whereas in pemphigus foliaceus acantholysis was restricted to the infundibulum [ 42 ]. Acantholysis was also observed in vellus hair follicles in 12/17 (70.6%) patients with pemphigus vulgaris and 9/15 (60.0%) patients with pemphigus foliaceus [ 42 ]. Furthermore, acantholysis was present in sebaceous gland ducts in 3/17 (17.6%) patients with pemphigus vulgaris and 1/15 (6.7%) patients with pemphigus foliaceus as well as sweat gland ducts in 2/17 (11.8%) and 2/15 (13.3%) patients, respectively [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

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The Significance of Scalp Involvement in Pemphigus: A Literature Review

Sar‐Pomian

Rudnicka

Olszewska

2018

BioMed Research International

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Scalp is a unique location for pemphigus because of the abundance of desmogleins localized in hair follicles. Scalp involvement is observed in up to 60% of patients in the course of pemphigus. The lesions may occasionally lead to alopecia. Unforced removal of anagen hairs in a pull test is a sign of high disease activity. Direct immunofluorescence of plucked hair bulbs is considered a reliable diagnostic method in patients with pemphigus. Follicular acantholysis is a characteristic histopathological feature of pemphigus lesions localized on the scalp. Trichoscopy may serve as a supplementary method in the diagnosis of pemphigus. This review summarizes the most recent data concerning scalp involvement in pemphigus vulgaris and pemphigus foliaceus. A systematic literature search was conducted in three medical databases: PubMed, Embase, and Web of Science. The analysis included literature data about desmoglein distribution in hair follicles, as well as information about clinical manifestations, histopathology, immunopathology, and trichoscopy of scalp lesions in pemphigus and their response to treatment.

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