Possible role of the bulge region in the pathogenesis of inflammatory scarring alopecia: lichen planopilaris as the prototype

Mobini, Narciss; Tam, Sam; Kamino, Hideko

doi:10.1111/j.0303-6987.2005.00399.x

Cited by 110 publications

(92 citation statements)

References 14 publications

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“…We also noticed an important observation where the inflammatory process involved the area of bulge region causing fibrosis and leaving the lower segment of the hair follicle intact. This pathologic finding may be responsible for the permanent damage to the hair organ and support the theory that the bulge region is the site of hair regeneration [16].  Thickening of basement membrane and mucin deposition in the dermis is a feature of DLE [17].…”

Section: Discussionsupporting

confidence: 65%

Lichen Planopilaris is a Common Scarring Alopecia among Iraqi Population

Sharquie¹,

Noaimi²,

Hameed³

2013

JCDSA

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Background: Scarring alopecia like discoid lupus erythematosus, lichenplanopilaris and scarring folliculitis are common skin problems where differentiations between them are often difficult in many cases. Objective: To report, study and evaluate cases of lichen planopilaris and characterize the different clinical points in favor of this disease. Patients and Methods: This case series descriptive study was done at Department of Dermatology-Baghdad Teaching Hospital from January 2010 to November 2012. Sixty seven patients were included where histological and dermatological examinations were carried out to all patients regarding all relevant points related to the disease. Punch biopsies were performed from ten patients for histopathological study. Results: The mean age of onset of the disease was 36.7 ± 5 years with a mean duration of the disease being 4.4 ± 3 years. The male to female ratio was 1.4:1. The characteristic lesions were pigmented scarring moth eaten alopecia surrounded by pigmented hyperkeratotic follicular papules involving mainly the fronto-vertical and parietal scalp. Conclusions: Lichen planopilaris is a common cause of scalp scarring alopecia in adult and it has many characteristic clinical features which can facilitate differentiation from other pathologic scalp conditions like discoid lupus erythematosus.

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Section: Discussionsupporting

confidence: 65%

Lichen Planopilaris is a Common Scarring Alopecia among Iraqi Population

Sharquie¹,

Noaimi²,

Hameed³

2013

JCDSA

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“…in lupus erythematosus or lichen planopilaris, where the destruction of bulge HFeSCs (see Fig.1) abolishes the hair follicle's capacity to cycle and to rhythmically regenerate itself, leading to scarring alopecia (Cotsarelis, 2006;Hiroi et al, 2006;Mobini et al, 2005;Paus, 2006). Likewise, a gradual loss of HF melanocyte stem cells may exhaust the HF pigmentary unit's capacity to generate itself and to produce melanin and thus likely plays a key role in hair graying (Commo et al, 2004;Nishimura et al, 2005;Sarin and Artandi, 2007).…”

Section: Clinical Importance Of Hair Follicle Stem Cellsmentioning

confidence: 99%

(Neuro-)endocrinology of epithelial hair follicle stem cells

Paus

Arck

Tiede

2008

Molecular and Cellular Endocrinology

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The hair follicle is a repository of different types of somatic stem cells. However, even though the hair follicle is both a prominent target organ and a potent, non-classical site of production and/or metabolism of numerous polypetide-and steroid hormones, neuropeptides, neurotransmitters and neurotrophins, the (neuro-) endocrine controls of hair follicle epithelial stem cell (HFeSC) biology remain to be systematically explored.Focussing on HFeSCs, we attempt here to offer a "roadmap through terra incognita" by listing key open questions, by exploring endocrinologically relevant HFeSC gene profiling and mouse genomics data, and by sketching several clinically relevant pathways via which systemic and/or locally generated (neuro-)endocrine signals might impact on HFeSC. Exemplarily, we discuss e.g. the potential roles of glucocorticoid and vitamin D receptors, the hairless gene product, thymic hormones, bone morphogenic proteins (BMPs) and their antagonists, and Skg-3 in HFeSC biology. Furthermore, we elaborate on the potential role of nerve growth factor (NGF) and substance P-dependent neurogenic inflammation in HFeSC damage, and explore how neuroendocrine signals may influence the balance between maintenance and destruction of hair follicle immune privilege, which protects these stem cells and their progeny. These considerations call for a concerted research effort to dissect the (neuro)-endocrinology of HFeSCs much more systematically than before. The hair follicle (HF) and its special, associated mesenchyme (i.e. the connective tissue sheath, CTS) are repositories of different types of somatic stem cells (epithelial, mesenchymal, neural, mesenchymal) (Cotsarelis, 2006; Kruse et al., 2006;Millar, 2005;Ohyama et al., 2006;Tiede et al. 2007;Waters et al., 2007;Yu et al., 2006). These HFassociated stem cell populations are critical for HF development and function, including HF pigmentation (Nishimura et al., 2002(Nishimura et al., , 2005Sarin and Artandi, 2007). Fig. 1 shows several important, recognized hair follicle-associated stem cell populations and their bestcharacterized location(s) in the pilosebaceous unit, though it must be kept in mind that the indicated ones are unlikely to be the only stem cell population associated with mammalian skin appendages (Tiede et al. 2007). Clinical importance of hair follicle stem cellsHair follicle epithelial stem cells (HFeSCs) are clinically important, since they can be key targets for pathological processes, such as an autoaggressive inflammatory cell attack on HFeSC, e.g. in lupus erythematosus or lichen planopilaris, where the destruction of bulge HFeSCs (see Fig.1) abolishes the hair follicle's capacity to cycle and to rhythmically regenerate itself, leading to scarring alopecia (Cotsarelis, 2006;Hiroi et al., 2006;Mobini et al., 2005;Paus, 2006). Likewise, a gradual loss of HF melanocyte stem cells may exhaust the HF pigmentary unit's capacity to generate itself and to produce melanin and thus likely plays a key role in hair graying (Commo et al., 2004;...

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“…They include alopecias due to inflammatory causes, 40% of which are accounted for by lichen planopilaris (LPP). 8 Cicatricial alopecia can affect the whole scalp, including the donor area from where hairs are removed for transplantation. 9 The aim of this study is to describe two cases of loss of transplanted hair, probably as a result of LPP.…”

Section: Introductionmentioning

confidence: 99%

Perda pilosa por líquen plano pilar após transplante capilar: relato de dois casos e revisão da literatura

Crisóstomo

et al. 2011

An. Bras. Dermatol.

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Androgenetic alopecia is often treated by follicular unit transplantation, a technique that involves minimal risk of hair loss because of the more resistant nature of the donor area. Lichen planopilaris is a cicatricial alopecia that causes permanent destruction of hair follicles. We report two cases of post-transplantation lesions compatible with lichen planopilaris in both recipient and donor areas. The quality of the hair follicles in the donor area was apparently compromised by lichen planopilaris, the probable cause of hair loss. Similar reports are rare. When lichen planopilaris is suspected, a biopsy of the scalp must be performed to avoid transplantation during disease activity. Keywords: Alopecia; Lichen planus; Transplantation; Transplantation, autologous Resumo: Alopecia androgenética é tratada com frequência por meio de microtransplante capilar, téc-nica em que os fios transplantados geralmente não caem, pois mantêm características da área doadora, mais resistente. O líquen plano pilar é uma alopecia cicatricial com permanente destruição pilosa. Este artigo relata dois casos de lesões compatíveis com líquen plano pilar em áreas receptora e doadora pós-transplante. A dominância da área doadora foi aparentemente sobrepujada pelo líquen plano pilar, que deve ter gerado a queda dos fios. Relatos semelhantes são raros. À suspeita de líquen plano pilar, devese biopsiar o couro cabeludo e evitar o transplante durante a atividade da doença.

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Possible role of the bulge region in the pathogenesis of inflammatory scarring alopecia: lichen planopilaris as the prototype

Cited by 110 publications

References 14 publications

Lichen Planopilaris is a Common Scarring Alopecia among Iraqi Population

Lichen Planopilaris is a Common Scarring Alopecia among Iraqi Population

(Neuro-)endocrinology of epithelial hair follicle stem cells

Perda pilosa por líquen plano pilar após transplante capilar: relato de dois casos e revisão da literatura

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