Horenstein Marcelo G, Simon Jessica
Dermatopathology Service, The Dermatology Group, 60 Pompton Avenue, Verona, NJ 07044, USA.
J Cutan Pathol. 2007 Oct;34(10):762-8. doi: 10.1111/j.1600-0560.2006.00696.x.
Premature desquamation of the inner root sheath (IRS) is described as a defining histologic feature of follicular degeneration syndrome/central centrifugal cicatricial alopecia (CCCA). However, IRS abnormalities have been noted in other types of alopecia.
We evaluated the IRS in terminal hair follicles with transverse sections stained with hematoxylin-eosin and Ziehl-Neelsen stains in 22 non-scarring (7 areata and 15 androgenetic) and 21 scarring (13 CCCA, 2 lichen planopilaris, 2 lupus erythematosus, 1 folliculitis decalvans and 3 end stage) alopecia cases. In addition, we evaluated 15 normal controls with longitudinal sections to establish the level of IRS desquamation.
The IRS was present in 99.5 +/- 0.01% (mean +/- standard error) of normal follicles at the level of the arrector pili muscle/sebaceous gland/sweat gland coil (L2) and variably present at higher levels. The IRS was present at L2 in 97.9 +/- 1.5% of alopecia areata, 87.4 +/- 5.3% of androgenetic alopecia, 59.3 +/- 7.0% of CCCA and 49.4 +/- 11.3% of other scarring alopecia follicles.
Premature desquamation of the IRS was identified in CCCA; however, it was also noted in other scarring alopecia cases. IRS premature desquamation is a non-specific histologic feature in scarring alopecia and cannot be used alone as a defining feature of CCCA.
内根鞘过早脱屑被描述为毛囊退化综合征/中央离心性瘢痕性秃发（CCCA）的特征性组织学表现。然而，在其他类型的脱发中也发现了内根鞘异常。
我们对22例非瘢痕性脱发（7例斑秃和15例雄激素性脱发）和21例瘢痕性脱发（13例CCCA、2例扁平苔藓性秃发、2例红斑狼疮、1例脱发性毛囊炎和3例终末期脱发）患者的终毛毛囊进行评估，采用苏木精-伊红染色和齐尔-尼尔森染色的横切片。此外，我们对15名正常对照者的纵切片进行评估，以确定内根鞘脱屑水平。
在立毛肌/皮脂腺/汗腺蟠管水平（L2），99.5±0.01%（平均值±标准误）的正常毛囊存在内根鞘，在更高水平则有不同程度的存在。在L2水平，斑秃患者的毛囊内根鞘存在率为97.9±1.5%，雄激素性脱发患者为87.4±5.3%，CCCA患者为59.3±7.0%，其他瘢痕性脱发患者为49.4±11.3%。
在CCCA患者中发现了内根鞘过早脱屑；然而，在其他瘢痕性脱发病例中也有发现。内根鞘过早脱屑是瘢痕性脱发的非特异性组织学特征，不能单独作为CCCA的特征性表现。
