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Suzuki T, Ito T, Gilhar A, Tokura Y, Reich K, Paus R. The hair follicle-psoriasis axis: Shared regulatory mechanisms and therapeutic targets. Exp Dermatol 2021; 31:266-279. [PMID: 34587317 DOI: 10.1111/exd.14462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/09/2021] [Accepted: 09/24/2021] [Indexed: 12/17/2022]
Abstract
It has long been known that there is a special affinity of psoriasis for the scalp: Here, it occurs most frequently, lesions terminate sharply in frontal skin beyond the hair line and are difficult to treat. Yet, surprisingly, scalp psoriasis only rarely causes alopecia, even though the pilosebaceous unit clearly is affected. Here, we systematically explore the peculiar, insufficiently investigated connection between psoriasis and growing (anagen) terminal scalp hair follicles (HFs), with emphasis on shared regulatory mechanism and therapeutic targets. Interestingly, several drugs and stressors that can trigger/aggravate psoriasis can inhibit hair growth (e.g. beta-blockers, chloroquine, carbamazepine, interferon-alpha, perceived stress). Instead, several anti-psoriatic agents can stimulate hair growth (e.g. cyclosporine, glucocorticoids, dithranol, UV irradiation), while skin/HF trauma (Köbner phenomenon/depilation) favours the development of psoriatic lesions and induces anagen in "quiescent" (telogen) HFs. On this basis, we propose two interconnected working models: (a) the existence of a bidirectional "hair follicle-psoriasis axis," along which keratinocytes of anagen scalp HFs secrete signals that favour the development and maintenance of psoriatic scalp lesions and respond to signals from these lesions, and (b) that anagen induction and psoriatic lesions share molecular "switch-on" mechanisms, which invite pharmacological targeting, once identified. Therefore, we advocate a novel, cross-fertilizing and integrative approach to psoriasis and hair research that systematically characterizes the "HF-psoriasis axis," focused on identification and therapeutic targeting of selected, shared signalling pathways in the future management of both, psoriasis and hair growth disorders.
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Affiliation(s)
- Takahiro Suzuki
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Taisuke Ito
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Amos Gilhar
- Skin Research Laboratory, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Allergic Disease Research Center, Chutoen General Medical Center, Kakegawa, Japan
| | - Kristian Reich
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Monasterium Laboratory, Münster, Germany
| | - Ralf Paus
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.,Monasterium Laboratory, Münster, Germany.,Centre for Dermatology Research, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Center, Manchester, UK
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Golińska J, Sar-Pomian M, Rudnicka L. Diagnostic Accuracy of Trichoscopy in Inflammatory Scalp Diseases: A Systematic Review. Dermatology 2021; 238:412-421. [PMID: 34265772 DOI: 10.1159/000517516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/29/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The common inflammatory scalp diseases, such as psoriasis, seborrheic dermatitis, lichen planopilaris, discoid lupus erythematosus, contact dermatitis, or pemphigus may share similar clinical features. OBJECTIVE To identify and systematically review the available evidence on the accuracy of trichoscopy in inflammatory scalp disorders. METHODS A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 58 articles were included in the analysis. RESULTS The following trichoscopy features were found to show the highest specificity for the respective diseases: in psoriasis: diffuse scaling, simple and twisted red loops, red dots and globules, and glomerular vessels; in seborrheic dermatitis: atypical vessels, thin arborizing vessels, and structureless red areas; in discoid lupus erythematosus: follicular plugs and erythema encircling follicles; in lichen planopilaris: milky red areas or fibrotic patches; in contact dermatitis: twisted red loops; in pemphigus foliaceus: white polygonal structures and serpentine vessels; in pemphigus vulgaris: red dots with whitish halo and lace-like vessels; and in dermatomyositis: lake-like vascular structures. LIMITATIONS Different nomenclature and variability in parameters, which were analyzed in different studies. CONCLUSION This systemic analysis indicates that trichoscopy may be used with high accuracy in the differential diagnosis of inflammatory scalp diseases.
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Affiliation(s)
- Joanna Golińska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland,
| | - Marta Sar-Pomian
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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Patsinakidis N, Meyer NH, Raap U. [Psoriasis]. MMW Fortschr Med 2020; 162:43-50. [PMID: 33164190 DOI: 10.1007/s15006-020-1458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Nikolaos Patsinakidis
- Universitätsklinik für Dermatologie und Allergologie, Klinikum Oldenurg AöR, Rahel-Straus-Str. 10, 26133, Oldenburg, Germany.
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Wikramanayake TC, Borda LJ, Miteva M, Paus R. Seborrheic dermatitis—Looking beyondMalassezia. Exp Dermatol 2019; 28:991-1001. [DOI: 10.1111/exd.14006] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/30/2019] [Accepted: 07/09/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Tongyu C. Wikramanayake
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Luis J. Borda
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Mariya Miteva
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Ralf Paus
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
- Centre for Dermatology Research University of Manchester Manchester UK
- NIHR Biomedical Research Centre Manchester UK
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Zander N, Sommer R, Schäfer I, Reinert R, Kirsten N, Zyriax B, Maul J, Augustin M. Epidemiology and dermatological comorbidity of seborrhoeic dermatitis: population‐based study in 161 269 employees. Br J Dermatol 2019; 181:743-748. [DOI: 10.1111/bjd.17826] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2019] [Indexed: 01/05/2023]
Affiliation(s)
- N. Zander
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - R. Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - I. Schäfer
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - R. Reinert
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - N. Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - B.‐C. Zyriax
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - J.‐T. Maul
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
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