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Dermatopathology: Practical & Conceptual January - March 1996
Searching for Diogenes: Uncloaking the Mantle
Martin Sangueza, MD
Michael Anthony Radonich, MD
A. Bernard Ackerman, MD
1876 Unna P
1889 Kölliker A
1895 Benda C
1897 Pinkus F
1902 Hertwig O
1927 Pinkus F
1935 Zimmermann KW
1956 Epstein W, Kligman AM
1963 Strauss JS, Pochi PE
1964 Madsen A
1971 Pinkus H
1972 Hegedus SL, Schorr WF
1976 Pinkus H and Mehregan AH
1987 Ishikawa K
1990 Leshin B, White WL
1991 Mehregan A, Hashimoto K
1992 Jakubovic H, Ackerman AB
1992 Montagna W, Kligman AM, Carlisle KS
1993 Narisawa Y, Hashimoto K, Kobda H
1993 Ackerman AB, deViragh P, and Chongchitnant N
1993 Steffen C
1994 Steffen C, Ackerman AB
1995 Mehregan AH, Hashimoto K, Mehregan DA, Mehregan DR
1995 deViragh PA
1996 Ackerman AB (
1995 deViragh PA
The 'mantle hair of Pinkus.' Dermatology 1995;191:8287.
Felix Pinkus is quoted as having considered mantles to be "a pathologic condition, namely, rudimentary sebaceous glands."
The author described mantles morphologically as follows: "Typically, mantles consist of undifferentiated basaloid cells. In some, focal sebum differentiation is seen. Exceedingly rare are mantles in which all the cells have fully differentiated into lipidized sebocytes. Even in those instances, mantles do not ramify to form cauliflower-like lobules characteristic of glands."
Mantles occur in all ages, from newborn to elderly.
Mantles could represent a fourth distinctive type of sebaceous gland, the other three being small glands associated with vellus follicles, large glands associated with terminal follicles, and sebaceous follicles.
In order to promote communication and enhance understanding of the mantle, it should be designated "mantle hair."
Mantles are rudimentary structures, but not pathologic ones.
Undifferentiated mantles consist of germinative cells. When, at puberty they differentiate, the result is fully formed sebaceous glands and ducts. En route to complete differentiation, mantles are partially differentiated, i.e., sebocytes (not sebum) are present at different stages of differentiation. When at menopause/andropause mantles involute, the findings are the reverse of those encountered in evolution of them.
Mantles are present mostly in older persons where they represent involution of sebaceous units, and in prepubescents where they represent anlagen of sebaceous units.
Mantles are not a type of sebaceous gland; they are both precursors and vestiges of sebaceous units.
"Mantle hair," and "mantle follicle" are misnomers. The mantle is neither a hair nor a follicle, but undifferentiated sebocytes that participate in a cycle.
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