Hair in psoriasis: a prospective, blinded scanning electron microscopic study

Area of Science:

• Dermatology
• Trichology
• Pathology

Background:

• Psoriasis is a chronic inflammatory skin condition.
• Hair abnormalities, including thinning and loss, can occur in psoriatic lesions.
• The specific morphological changes in hair shafts associated with psoriasis require further investigation.

Purpose of the Study:

• To compare hair shaft morphology in psoriatic plaques with nonlesional skin and healthy controls.
• To identify specific ultrastructural changes in hair from psoriatic lesions.
• To determine if observed hair changes correlate with hair thinning or loss in psoriasis.

Main Methods:

• Observer-blinded prospective study design.
• Scanning electron microscopy (SEM) examination of hair samples.
• Comparison of hair morphology from psoriatic plaques, adjacent nonlesional skin, and healthy controls.

Main Results:

• Micropits and macropits, dystrophy, upturned cuticular edges, and fissures were observed in all groups.
• Micropits were significantly more frequent in lesional psoriatic hair compared to controls.
• Dystrophic changes were significantly more severe in lesional psoriatic hair.

Conclusions:

• The increased frequency and severity of micropits and hair dystrophy in psoriatic plaques may contribute to hair thinning and loss.
• SEM is a valuable tool for identifying subtle hair shaft abnormalities in dermatological conditions.
• Further research is warranted to elucidate the pathomechanisms linking these hair changes to psoriasis.