Messenger A G, Bleehen S S
Br J Dermatol. 1984 Feb;110(2):155-62. doi: 10.1111/j.1365-2133.1984.tb07461.x.
Light and electron microscopic studies have been carried out on fifteen regrowing white anagen hair follicles from seven patients with alopecia areata. Seven bulbs showed evidence of cell injury that was concentrated in cortical keratocytes. Lower bulb matrix cells appeared undamaged though in six bulbs apoptotic degeneration was seen in the lower bulb keratocytes, perhaps indicating early catagen transformation. Melanocytes were identified in all the bulbs except those from one patient. The number of melanocytes and their melanization were much less than in the normal pigmented follicle, and pigment transfer was rarely seen. It is proposed that alopecia areata is a disease of differentiating cortical keratocytes. The failure of pigmentation in the regrowing white hair may be post-inflammatory, but the various other pigmentary features of alopecia areata, especially the sparing of senile white hairs, suggest that pigmentary mechanisms in the hair bulb are of primary importance in the pathogenesis of this disorder.
对7例斑秃患者的15个再生长的白色生长期毛囊进行了光镜和电镜研究。7个毛囊球显示出细胞损伤的证据，损伤集中在皮质角质形成细胞。较低部位的毛囊球基质细胞似乎未受损，不过在6个毛囊球中，较低部位的毛囊球角质形成细胞出现了凋亡性退变，这可能表明早期进入了退行期转变。除了1例患者的毛囊球外，在所有毛囊球中均鉴定出黑素细胞。黑素细胞的数量及其黑素化程度远低于正常有色素的毛囊，且很少见到色素转移。有人提出斑秃是一种分化中的皮质角质形成细胞疾病。再生长的白发中色素沉着失败可能是炎症后所致，但斑秃的各种其他色素特征，尤其是老年白发未受累，提示毛囊球中的色素机制在该疾病的发病机制中至关重要。
