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< Current issue
Dermatopathology: Practical & Conceptual April - June 1995
>
Searching for Diogenes: Bulge-Activation Hypothesis Part II—The Bulge is Not a Bulge
Michael Radonich
Cosimo Misciali, MD
A. Bernard Ackerman, MD
Introduction
1876 Unna
1877 Schulin
1883 Unna
1892 Garcia
1904 Stöhr
1927 Felix Pinkus
1935 Zimmermann
1951 Hermann Pinkus
1958 Hermann Pinkus
1961 Sanderson & Thiede
1961 Sanderson
1964 Madsen
1964 Montagna
1984 Headington
1986 Mehregan
1987 Headington & Astle
1990 Leshin & White
1990 Cotsarelis, Sun, Lavker
1991 Sun, Cotsarelis, Lavker
1991 Lavker, Cotsarelis, Wei, Sun
1991 Lane, Wilson, Hughes, Leigh
1992 Jaworsky, Kligman, Murphy
1993 Yang, Lavker, Sun
1993 Lavker, Miller, Wilson, Costarelis, Wei, Yang, Sun
1993 Headington
1993 Whiting
1993 Kobayashi, Rochat, Barrandon
1994 Rochat, Kobayashi, Barrandon
References
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1904 Stöhr
Entwicklungsgeschichte des Menschlichen Wollhaares. Anat Hefte Abt. 1904;XXIII:3-66 (
Fig. 5
).
View Figure
Fig. 5 [Fig. 14] Tangential view of a germinal cone, tip of the inner root sheath, m. arrector, sebaceous gland, outer root sheath, undifferentiated cells of the hair cone, bulge, glassy membrane, papilla. (Reproduced with permission.) Key: Tangentialschnitt eines Haarzapfens = secondary hair germ; Spitze der inneren Wurzelscheide = tip of inner root sheath; Talgdrüse = sebaceous glands; Äussere Wurzelscheide = outer root sheath; Indifferente Zellen des Haarkegels = hair cone; Wulst = bulge; Glashaut = vitreous membrane; Papille = papilla; M. arrector = arrector pili muscle
Message
"The bulge" develops independent of any pull upon it of a musculus erector pili.
"The bulge" does not give rise to a new follicle. Its function is to facilitate retraction of a club hair during a follicular cycle.
The outgrowths that constitute "the bulge" are pathologic.
Critique
Stöhr denied that "the bulge" functions as the source of cells for a new follicle, but he did not propose an alternative explanation for the reservoir of them.
"The bulge" plays no role in the ascent of a club hair. A club hair comes to rest (telogen) at the base of the isthmus.
Bulges, i.e., protuberances of isthmic epithelium, contrary to the views of Unna and Stöhr, are normal, not pathologic.
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