Journal of Dermatology and Dermatologic Diseases

ISSN: 2684-4281

Open Access

Behavior of Hair Follicles in Vitiligo: Clinical Presentation and Discussion


Sherif S Awad

The color of the hair is dependent on the existence and function of the melanin producing cells, the melanocytes, in the hair matrix of the bulb. In vitiligo, the loss of color of the affected skin is due to loss of epidermal melanocytes, which may also be accompanied by loss of the bulbar melanocytes with subsequent loss of the hair color. Lymphocytic immune-cytotoxic process maybe involved in the destruction of epidermal or bulbar melanocytes. Hair depigmentation is said to follow surface depigmentation in long standing disease. This delay in development of leukotrichia in vitiligo could be claimed to the difference in melanization nature of hair follicle in comparison to epidermal melanization process. In rare cases, follicular melanocytes can be primarily destroyed in vitiligo without destruction of epidermal melanocytes. Apart from mature melanocytes, the hair follicles possess also immature form of melanocytes residing in the bulge area, outer root sheath, dermal papilla and sometimes the hair matrix. These immature cells usually escape the vitiligo immune destructive process. The existence of leukotrichia used to be a sign of disease recalcitrance and expected treatment failure. In such cases several surgical procedures were introduced to help repigmenting the skin. It was found that activation of the immature melanocytic precursors in hair follicles is responsible for the repigmentation of epidermis and hair follicles due to the supply with new mature melanocytes.


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