SnapshotDx Quiz: December 2018

November 2018 in “ Journal of Investigative Dermatology ”

Fabrizio Galimberti, Preetha Kamath, Mariya Miteva

Lichen Planopilaris cicatricial alopecia immune privilege hair follicle bulge epithelial stem cells CD8+ T cells interferon-gamma epithelial-to-mesenchymal transition peroxisome proliferator-activated receptor-gamma LPP scarring alopecia eSC IFN-γ EMT PPAR-γ

TLDR Lichen Planopilaris causes irreversible hair loss due to immune attacks on hair stem cells, but modulating PPAR-γ might help treat it.

The document discussed a quiz from the Journal of Investigative Dermatology focusing on diagnosing hair and scalp conditions, with the correct diagnosis being Lichen Planopilaris (LPP), a type of cicatricial alopecia leading to irreversible hair loss. It highlighted the immune privilege of the hair follicle bulge, which contains epithelial stem cells (eSC) protected from autoimmune attacks. In LPP, this privilege was compromised, making eSC vulnerable to destruction by CD8+ T cells, with interferon-gamma (IFN-γ) playing a role in this process. The document also explored the epithelial-to-mesenchymal transition (EMT) and the role of peroxisome proliferator-activated receptor (PPAR)-γ in maintaining hair follicle health, suggesting that PPAR-γ modulation could potentially reverse early EMT changes, offering insights into therapeutic approaches for LPP.

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research Lichen Planopilaris and Frontal Fibrosing Alopecia as Model Epithelial Stem Cell Diseases

80 citations , April 2018 in “Trends in Molecular Medicine”

Lichen Planopilaris and Frontal Fibrosing Alopecia may help us understand hair follicle stem cell disorders and suggest new treatments.

Divergent Proliferation Patterns of Distinct Human Hair Follicle Epithelial Progenitor Niches In Situ and Their Differential Responsiveness to Prostaglandin D2

research Divergent Proliferation Patterns of Distinct Human Hair Follicle Epithelial Progenitor Niches In Situ and Their Differential Responsiveness to Prostaglandin D2

21 citations , November 2017 in “Scientific Reports”

Different human hair follicle stem cells grow at different rates and respond differently to a baldness-related compound.

research Epithelial-To-Mesenchymal Stem Cell Transition In A Human Organ: Lessons From Lichen Planopilaris

71 citations , October 2017 in “Journal of Investigative Dermatology”

PPAR-γ agonists like pioglitazone may help manage lichen planopilaris but don't fully reverse scarring.

research Clinical Description of Frontal Fibrosing Alopecia with Concomitant Lichen Planopilaris

13 citations , September 2017 in “Skin appendage disorders”

Some women with Frontal Fibrosing Alopecia also have Lichen Planopilaris, which can lead to more symptoms and affect hair outside the scalp.

research Trichoscopy of Dissecting Cellulitis of the Scalp: Exclamation Mark Hairs and White Dots as Markers of Disease Chronicity

15 citations , November 2016 in “Journal of The American Academy of Dermatology”

Exclamation mark hairs suggest early scalp disease, while white dots indicate it's chronic.

research Psoriatic Alopecia

41 citations , July 2015 in “Clinical and Experimental Dermatology”

Psoriasis can cause temporary or permanent hair loss.

research Dermoscopic Findings in Scalp Psoriasis and Seborrheic Dermatitis: Two New Signs; Signet Ring Vessel and Hidden Hair

40 citations , December 2014 in “Indian Journal of Dermatology”

Two new signs, 'signet ring vessels' and 'hidden hairs,' help tell apart scalp psoriasis and seborrheic dermatitis.

research Clinicopathologic Lessons in Distinguishing Cicatricial Alopecia: 7 Cases of Lichen Planopilaris Misdiagnosed as Discoid Lupus

15 citations , September 2014 in “Journal of The American Academy of Dermatology”

Seven patients were misdiagnosed with discoid lupus instead of lichen planopilaris due to similar symptoms, showing the need for careful diagnosis in scarring hair loss conditions.

research A Case Series of 46 Patients With Lichen Planopilaris: Demographics, Clinical Evaluation, and Treatment Experience

47 citations , June 2014 in “Journal of Dermatological Treatment”

Most treatments for lichen planopilaris were found to be generally unsatisfactory.

Human Epithelial Hair Follicle Stem Cells and Their Progeny: Current State of Knowledge, the Widening Gap in Translational Research and Future Challenges

research Human Epithelial Hair Follicle Stem Cells and Their Progeny: Current State of Knowledge, the Widening Gap in Translational Research and Future Challenges

106 citations , March 2014 in “BioEssays”

We need more research to better understand human hair follicle stem cells for improved treatments for hair loss and skin cancer.

research Lichen Planopilaris Is Characterized By Immune Privilege Collapse Of The Hair Follicle's Epithelial Stem Cell Niche

220 citations , June 2013 in “The Journal of Pathology”

Lichen planopilaris may be an autoimmune disease causing hair loss due to immune system issues in hair follicles.

research A Comprehensive Approach to Hair Pathology of Horizontal Sections

12 citations , June 2013 in “The American Journal of Dermatopathology”

A new method using visual aids to diagnose hair diseases was effective after brief training.

research Dermatoscopy of Hair Shaft Disorders

68 citations , August 2012 in “Journal of the American Academy of Dermatology”

Dermatoscopy is a useful tool for diagnosing hair disorders and can help choose samples for more detailed analysis.

research Lichen Planopilaris: Update on Diagnosis and Treatment

160 citations , March 2009 in “Seminars in Cutaneous Medicine and Surgery”

New insights show Lichen Planopilaris is a rare, scarring hair loss condition, hard to treat, mainly affecting middle-aged women, and significantly impacts mental health.

research Lichen Planopilaris: Chronic Scarring Alopecia with Autoimmune Component

90 citations , July 2008 in “Dermatologic therapy”

Lichen planopilaris is a chronic, scarring hair loss condition with no definitive cure, requiring accurate diagnosis and treatment to manage symptoms.