Involvement of the Bulge Region with Decreased Expression of Hair Follicle Stem Cell Markers in Senile Female Cases of Alopecia Areata

    Ryota Yoshida, Kyuto Tanaka, Masayuki Amagai, Manabu Ohyama
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    TLDR Decreased CD200 in hair follicles may cause immune issues in some alopecia areata cases.
    The study investigated the expression levels of stem cell markers, particularly CD200, in two elderly female cases of alopecia areata (AA) with unusual lymphocytic infiltrates in both the bulge and bulbar regions of hair follicles. It compared these cases to common AA cases without bulge involvement. The results showed that while K15 levels remained consistent in unaffected bulge lesions across both groups, CD200 levels were decreased in the bulge-involving AA group. In affected bulge lesions, both K15 and CD200 levels were reduced in the bulge-involving AA cases compared to common AA cases. The study concluded that the selective downregulation of CD200 in the bulge area might lead to the loss of immune privilege, contributing to the unusual bulge involvement in a subset of AA.
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