Ultrastructural Abnormalities in the Dermal Papillae of Lesional and Clinically Normal Follicles from Alopecia Areata Scalps

This study investigated the ultrastructure of dermal papillae in both lesional and clinically normal follicles from alopecia areata scalps. It found that dermal papillae in alopecia areata, even in non-balding areas, were less organized and showed signs of cell injury, abnormal pigment levels, increased fibrous material, and thickened dermal papilla-epithelial junctions. These abnormalities suggest that dermal papilla cells in alopecia areata may have impaired ability to synthesize and transport regulatory factors, indicating a potential early pathological role in the condition. However, it remained unclear whether these changes were a primary cause or a secondary response in the disease process.