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 ORIGINAL ARTICLE
Year : 2019  |  Volume : 85  |  Issue : 5  |  Page : 455--461

A cross-sectional study of the histopathology and immunology of alopecia areata: Unearthing the role of the Janus kinase–signal transducer and activator of transcription pathway


1 Department of Dermatology, Maulana Azad Medical College, Govind Ballabh Pant Hospital, New Delhi, India
2 Department of Pathology, Maulana Azad Medical College, Govind Ballabh Pant Hospital, New Delhi, India

Correspondence Address:
Dr. Vineet Relhan
Department of Dermatology, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi - 110 002
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijdvl.IJDVL_738_17

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Background: Alopecia areata is an autoimmune disease that occurs as a result of the loss of the inherent immune privilege of the hair follicle. It has been recently demonstrated that the interferon-γ/interleukin-15 feedback loop that signals via the Janus kinase–signal transducer and activator of transcription pathway is critical to the breakdown of this immune privilege. Aims: To evaluate the immunological distribution of CD4+ T-cells, CD8+ T-cells, phosphorylated signal transducer and activator of transcription 1 and study its relation with the clinical and histopathological findings of the disease. Materials and Methods: A total of 30 patients of alopecia areata were included in the study. Following a detailed history and clinical examination, a scalp biopsy was performed. Histopathology was studied and immunohistochemistry was done to demonstrate the positivity and distribution of CD4+ T-cells, CD8+ T-cells and phosphorylated signal transducer and activator of transcription 1. Results: The follicular count, number of anagen and terminal hair were found to be decreased, whereas the catagen, telogen and vellus hair were found to be increased in number. A peribulbar CD4+ T-cell infiltrate was seen in 70% cases, whereas a CD8+ T-cell infiltrate was seen in 83.3% cases. An intrabulbar CD4+ T-cell infiltrate was seen in 26.7% cases, whereas a CD8+ T-cell infiltrate was seen in 70% cases. Among the 25 hair follicles dermal papilla identified, 36.8% cases were found to be positive for phospho-signal transducer and activation of transcription-1. Limitations: The drawbacks of our study included a small sample size and the use of only vertical sectioning for the scalp biopsy samples. Conclusion: Phosphorylated signal transducer and activator of transcription 1 positivity as an indicator of signalling via the Janus kinase-1/2 pathway was seen in 36.8% of our cases highlighting the integral role of this pathway in the pathogenesis of alopecia areata.






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