Early Sebaceous Gland Destruction in Discoid Lupus Erythematosus: Are the Sebaceous Glands Prime Target Leading to Cicatricial Alopecia?

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Early Sebaceous Gland Destruction in Discoid Lupus Erythematosus: Are the Sebaceous Glands Prime Target Leading to Cicatricial Alopecia?

Khalid Mahmood* and Anwar Ul Haque**
* Consultant Dermatologist, PAF Hospital, Islamabad, Pakistan.
** Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad.

We have observed over the years that in lesions of discoid lupus erythematosus (DLE), the inflammation is usually more intense around the mid follicular level, at the site where sebaceous glands are located. The sebaceous glands seem to be the first target in DLE as is evident from significant early damage to the sebaceous glands in the form of lymphocytic infiltration of the sebaceous glands, disruption of the glandular structure and formation of sebaceous granulomas comprising foreign body giant cells containing partially digested sebaceous material (Figure 1 & 2). It appears that the
sebaceous glands are the first adnexal structures to disappear even before the hair follicles, in DLE. In many lesions of DLE, it is not infrequently observed that the sebaceous glands have disappeared and hair follicles are, although inflamed, but still intact raising the possibility that sebaceous glands might well be the primary target of immune damage in DLE leading to secondary cicatricial alopecia.

         

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