Research Article of American Journal of Clinical Research and Reviews
Clinical and Histopathological Findings in Patients with Follicular Dermatoses: All Skin Diseases Starts in the Hair Follicles as New Hypothesis
*Professor Khalifa E. Sharquie MD,PhD,FRCP Edin, *Professor Adil A. Noaimi MD, DDV, FICMS, **Dr. Rusul A. Flayih MD.
*Department of Dermatology, College of Medicine, University of Baghdad. Iraqi and Arab Board for Dermatology and Venereology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq.
** Center of Dermatology; Baghdad Teaching Hospital; Medical City, Baghdad, Iraq.
Background: Follicular dermatoses are group of skin diseases characterised by follicular lesions during the course of the disease.
Objective: To gather all skin diseases where there is follicular lesions to be evaluated in order to reach the hypothesis that hair follicles are the most principal target area in the etiopathogenesis of these skin disorders.
Patients and Methods: This is a descriptive, clinical and histopathological study that was carried out at the Department of Dermatology, Baghdad Teaching Hospital, Medical City, and Baghdad, Iraq during the period from November 2018 to August 2019. Sixty patients with different follicular dermatoses were enrolled and all socio- demographic data related to the disease was obtained from each patient, in addition to physical examination was performed for each patient. Biopsies were taken from 40 patients, for histopathological evaluation.
Results: Sixty patient, were included in this study, 35 patients males and 25 patients females with male to female ratio 1.4:1. Their ages ranged from 1-80(30.2 ± 16.96) years. All patients had follicular lesions. The histopathological results showed: perifollicular lymphocytes, follicular invasion and degeneration, follicular plugging, fibrous tract remnant, perifollicular melanophages and absent melanin pigment in the epidermis of patients with vitiligo.
Conclusion: The result of the present study showed that all skin diseases start in the hair follicles and might spread to involve the proper epidermis, and the lesions could be microscopic or visible to the naked eye. The hair follicles have many anatomical and immunological privileges that make it easy to be an early target for any cutaneous pathological process. Hence these findings are in support of new hypothesis that say: all skin diseases starts in the hair follicles and then spread to attack the adjacent proper epidermis
Keywords: follicular dermatoses, hair follicle, immunological privilege
How to cite this article:
Khalifa E. Sharquie, Adil A. Noaimi, Rusul A. Flayih. Clinical and Histopathological Findings in Patients with Follicular Dermatoses: All Skin Diseases Starts in the Hair Follicles as New Hypothesis. American Journal of Clinical Research and Reviews, 2020; 4:17. DOI:10.28933/ajcrr-2020-04-2006
1. Sharquie KE, Noaimi AA, Mijthab ZM. Chronic scalp folliculitis versus acne vulgaris (observational case series study). J Clin Exp Dermatol Res. 2012; 3(153):2.
2. Thomas M, Khopkar US. Keratosis pilaris revisited: is it more than just a follicular keratosis? Int J Trichol 2012; 4:255-8.
3. Sharquie KE, Noaimi AA, Hameed AF. Lichen Planopilaris is a Common Scarring Alopecia among Iraqi Population. Journal of Cosmetics, Dermatological Sciences and Applications. 2013 Aug 16; 3(3):35-9.
4. Messenger AG, de Berker DA, & Sinclair RD. Disorders of hair in: Burns T, Breathnach S, Cox N, Griffiths C. Rook’s Text Book of Dermatology. 8th ed. UK: Wiley-Blackwell, 2010; 4, 66: 1-11.
5. Erdoğan B. Anatomy and Physiology of Hair. In Hair and Scalp Disorders 2017 May 3. (2):21.
6. Thomas LJ, Dadzie OE, Francis N, Morar N. Follicular Psoriasis-A Forgotten Entity?. Open Dermatology Journal. 2010/4:95-6.
7. Berth‐Jones J. Eczema, lichenification, prurigo and erythroderma in: Burns T, Breathnach S, Cox N, Griffiths C. Rook’s Text Book of Dermatology. 8th ed. UK: Wiley-Blackwell, 2010; Mar 22/1:1-51.
8. Sharquie KE, Noaimi AA. Follicular vitiligo: the present clinical status. Our Dermatology Online. 2016 Apr 1; 7(2):176.
9. Cotsarelis G, Botchkarev V. Biology of hair follicles. In: Goldsmith LA, Kataz SI, Gilchrest BA, Paller SA, Leffell DJ, Wolf K (eds). Fitzpatrick’s Dermatology in General Medicine, 8th ed. New York, McGrow Hill Company, 2012; 1, 15, 86: 960-8.
10. Paus R, Cotsarelis G. The biology of hair follicles. New England journal of medicine. 1999 Aug 12; 341(7):491-7.
11. Christoph T, Müller-Röver S, Audring H. The human hair follicle immune system: cellular composition and immune privilege. . British Journal of Dermatology, 2000/142:862–73.
12. Paus R, Ito N, Takigawa M. The hair follicle and immune privilege. J Investig Dermatol Symp Proc 2003/8:188–94.
13. Groscurth P. Anatomy of sweat glands. In Hyperhidrosis and botulinum toxin in dermatology 2002, 30, 1-9. Karger Publishers.
This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.