LB965 Follicular Trochanters: A Potential Mechanism for Stem Cell Depletion in Scarring Alopecia

July 2020 in “ The journal of investigative dermatology/Journal of investigative dermatology ”

Fritzlaine C. Roche, Andrew S. Fischer, Kevin Gaddis, Tzvete Dentchev, Susan C. Taylor, John T. Seykora

scarring alopecia central centrifugal cicatricial alopecia lichen planopilaris discoid lupus erythematosus keratin 15 K15 hair follicle stem cells perifollicular fibrosis CCCA LPP DLE

TLDR Hair follicle bumps with stem cells might contribute to permanent hair loss by getting disconnected due to scarring.

The study investigated the role of follicular trochanters in scarring alopecia by examining 30 cases of central centrifugal cicatricial alopecia (CCCA), lichen planopilaris (LPP), and discoid lupus erythematosus (DLE). It was found that 10 out of 30 cases had keratin 15 (K15)-positive trochanters, with a higher prevalence in CCCA (60%) compared to DLE and LPP (20% each). The number of trochanters per follicle and the number of K15 stem cells were significantly greater in CCCA than in DLE and LPP (P<0.05). These findings suggested that fibrosis-associated trochanters, which contain hair follicle stem cells, might contribute to the pathomechanism of CCCA by representing a disrupted stem cell niche separated from follicles by perifollicular fibrosis.

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