Diffuse Alopecia With Stem Cell Folliculitis

    February 1999 in “ American Journal of Dermatopathology ”
    Steven Kossard
    TLDR Lymphocytes may hinder hair stem cells, causing hair loss without scarring.
    A 34-year-old woman experienced an 8-year history of slowly progressive diffuse nonscarring alopecia with reduced hair density. Scalp biopsies revealed increased miniaturized follicles and a distinctive lymphocytic infiltrate in the stem cell-rich regions, suggesting a possible stem cell folliculitis. This pattern was similar to reactions seen in graft versus host disease and androgenetic alopecia. The presence of peribulbar lymphocytic inflammation suggested a variant of alopecia areata. The findings indicated that lymphocytes might inhibit stem cell function without destroying them, prompting a reconsideration of cases classified as chronic diffuse alopecia areata.
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