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Eruptive Necrotizing Infundibular Crystalline Folliculitis: An Expression of an Abortive Sebaceous Follicular Repair Pathway Linked to Committed Infundibular Stem Cells?
- Source :
-
The American Journal of dermatopathology [Am J Dermatopathol] 2021 Dec 01; Vol. 43 (12), pp. 867-870. - Publication Year :
- 2021
-
Abstract
- Abstract: Necrotizing infundibular crystalline folliculitis is a rare entity, which is a distinctive clinical and histopathological entity. Eruptive yellow waxy umbilicated folliculocentric plugs clinically correspond to pale crystalline filaments embedded in an amorphous sebum-rich material. Remarkably, only the superficial infundibular ostia remain, and the distended cavity is devoid of a follicular or sebaceous gland remnant. The pathogenesis of this enigmatic event remains to be established. The emergence of necrotizing infundibular crystalline folliculitis (NICF) as a paradoxical side effect of antitumor inhibitors epidermal growth factor receptor vascular endothelial growth factor and more recently programmed death-1 represents the expression of altered molecular pathways that underpin the pathogenesis of NICF. To explore these pathways, it is necessary to explore the hierarchy of follicular stem cells, particularly the potential role of committed infundibular stem cells that play a key role in wound healing. Committed infundibular stem cells are closely linked to the sebaceous gland stem cell axis, and this has relevance in the process of homeostatic repair of sebaceous follicles in the wake of folliculitis. The unscheduled modulation of this infundibular homeostatic sebaceous repair axis by epidermal growth factor receptor vascular endothelial growth factor, and programmed death-1 may lead to an aberrant outcome with metaplasia of infundibular keratinocytes to sebocytes. In the absence of sebaceous gland differentiation, these metaplastic infundibular sebocyte cells would lead to the consumption and loss of the infundibulum as a result of holocrine sebum production. This conceptual pathogenic pathway for NICF is constructed by incorporating recent advances in the fields of follicular stem cells, wound repair, follicular homeostasis, regulatory T cells, and molecular pathways linked to the biologicals inducing NICF.<br />Competing Interests: The author declares no conflicts of interest.<br /> (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Subjects :
- Angiogenesis Inhibitors adverse effects
Antineoplastic Agents adverse effects
Folliculitis chemically induced
Hair Follicle drug effects
Humans
Immune Checkpoint Inhibitors adverse effects
Sebaceous Glands pathology
Stem Cells drug effects
Vascular Endothelial Growth Factor A antagonists & inhibitors
Folliculitis pathology
Hair Follicle pathology
Stem Cells pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1533-0311
- Volume :
- 43
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The American Journal of dermatopathology
- Publication Type :
- Academic Journal
- Accession number :
- 34735106
- Full Text :
- https://doi.org/10.1097/DAD.0000000000002022