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Dermatopathology: Practical & Conceptual April - June 1995
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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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1961 Sanderson & Thiede
The microanatomy of normal skin as seen in thick sections. Br J Dermatol. 1961;73:43-56.
Message
"The bulge" is not found consistently, in contrast to the observations of Stohr and F. Pinkus.
Irregularities of the outer sheath are seen in association with the point of attachment of the muscle of hair erection, i.e., midway between the bulb and the junction of the sebaceous gland with the follicle.
Critique
The authors did not find "the bulge" because they did not realize that the irregularities of the outer sheath at the site of attachment of fascicles of hair arrector muscle were, in reality, bulges.
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