title: Sebaceous gland loss and inflammation in scarring alopecia: a potential role in pathogenesis.
abstract: BACKGROUND
  Primary scarring alopecia (SA) comprises a group of disorders with poorly defined origins. Improving diagnostic and therapeutic capabilities requires a better understanding of their pathogenesis.
  
  
  OBJECTIVE
  We sought to assess the frequency of sebaceous gland loss in SA and to identify the role of sebaceous gland and sebaceous gland duct inflammation in the pathogenesis of SA.
  
  
  METHODS
  Ninety specimens submitted with a clinical history of alopecia, both scarring and nonscarring, were reviewed. Samples were scored based on sebaceous gland, sebaceous duct, and follicle inflammation.
  
  
  RESULTS
  Sebaceous gland loss was much more common in cases of SA (>53% of follicles on average) than non-SA (<5% of follicles on average). Many cases of SA showed residual affected follicles with an absence of sebaceous glands. Sebaceous gland duct inflammation was often more frequent and severe than gland inflammation in SA.
  
  
  CONCLUSIONS
  Sample size was limited in some alopecia entities. Inflammation was graded by means of subjective observation.
  
  
  CONCLUSIONS
  This study demonstrates that sebaceous gland loss is a common and early finding among SA. In addition, sebaceous gland and/or duct inflammation may play a role in initiating or accelerating follicular damage during the development of SA.
authors.affiliation: Department of Pathology, Tufts Medical Center, Tufts University Medical School, Boston, Massachusetts.
authors.forename: Tariq
authors.initials: T
authors.lastname: Al-Zaid
authors.affiliation: Departments of Cancer Biology and Pathology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Stefan
authors.initials: S
authors.lastname: Vanderweil
authors.affiliation: Department of Pathology, Lahey Clinic Medical Center, Tufts University Medical School, Burlington, Massachusetts.
authors.forename: Artur
authors.initials: A
authors.lastname: Zembowicz
authors.affiliation: Departments of Cancer Biology and Pathology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: stephen.lyle@umassmed.edu.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lyle
mesh_terms: D000505:Alopecia / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D002921:Cicatrix / Q000473:pathology*; D018859:Hair Follicle / Q000473:pathology; D006801:Humans; D007249:Inflammation; D012627:Sebaceous Glands / Q000473:pathology*