Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
Biomed Res Int. 2018 Mar 25;2018:6154397. doi: 10.1155/2018/6154397. eCollection 2018.
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.
头皮是天疱疮的一个独特部位，因为毛囊中存在丰富的桥粒芯糖蛋白。在天疱疮的病程中，多达 60%的患者会出现头皮受累。头皮病变偶尔会导致脱发。拔毛试验中，生长期毛发不自主拔出是疾病高度活动的一个标志。直接免疫荧光法检查拔下的头发毛囊被认为是天疱疮患者的一种可靠诊断方法。棘层松解是位于头皮的天疱疮病变的特征性组织病理学特征。毛发镜检查可作为天疱疮诊断的一种补充方法。本文综述了最近关于寻常型天疱疮和落叶型天疱疮头皮受累的相关数据。在三个医学数据库（PubMed、Embase 和 Web of Science）中进行了系统的文献检索。分析包括有关桥粒芯糖蛋白在毛囊中的分布的文献数据，以及有关天疱疮头皮病变的临床表现、组织病理学、免疫病理学和毛发镜检查及其对治疗反应的信息。
