Department of Dermatology, University of Sao Paulo, Sao Paulo, Brazil.
Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota.
Exp Dermatol. 2020 Mar;29(3):278-281. doi: 10.1111/exd.13834. Epub 2018 Dec 21.
Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are lymphocyte-mediated scarring alopecias which clinically affect primarily the anterior and mid-scalp. However, unaffected scalp areas have not yet been investigated in a systemic manner. In this study, we assessed histopathologic changes in affected and unaffected scalp in both diseases and healthy control subjects and compared these findings with clinical signs and scalp symptoms. We have demonstrated that "normal-appearing" scalp that is devoid of clinical lesions of LPP and FFA showed lymphocytic perifollicular inflammation around the isthmus/infundibulum areas in 65% of biopsy specimens, perifollicular fibrosis in 15% and mucin deposits in 7.5% of the cases. None of these findings were found in control samples. No direct correlation was found between the degree of histopathological inflammation, scalp symptoms and clinical lesions in the corresponding affected scalp areas. This preliminary study suggests that both diseases may be more generalized processes which affect the scalp and therefore need systemic or total scalp therapy.
瘢痕性类天疱疮（LPP）和额部纤维性脱发（FFA）是两种由淋巴细胞介导的瘢痕性脱发，临床上主要影响前头部和头中部。然而，尚未系统地研究未受影响的头皮区域。在这项研究中，我们评估了两种疾病和健康对照组中受累和未受累头皮的组织病理学变化，并将这些发现与临床体征和头皮症状进行了比较。我们已经证明，“正常外观”的头皮，即没有 LPP 和 FFA 的临床病变的头皮，在 65%的活检标本中显示峡部/漏斗部周围的毛囊周围淋巴细胞炎症，15%的病例有毛囊周围纤维化，7.5%的病例有粘蛋白沉积。这些发现均未在对照组样本中发现。在相应受累头皮区域中，组织病理学炎症的程度、头皮症状和临床病变之间没有直接的相关性。这项初步研究表明，这两种疾病可能是更广泛的影响头皮的疾病，因此需要全身或整个头皮治疗。
