Anatomía microscópica del folículo piloso

  • Rodrigo Restrepo
Palabras clave: histología del folículo piloso, cuero cabelludo, biopsia, alopecia


En este artículo revisaremos los aspectos más relevantes de la histología del folículo piloso que sean particularmente útiles para el dermatopatólogo que se enfrenta rutinariamente con el diagnóstico de las alopecias cicatriciales y no cicatriciales. Se hace énfasis en los criterios histológicos y aspectos prácticos más importantes.

Biografía del autor/a

Rodrigo Restrepo

Programa de Especialización en Dermatopatología, Facultad de Medicina, Universidad CES; instructor asociado de Dermatopatología, Dermatología, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia.


1. Hardy A. Was man more aquatic in the past? New Sci. 1960;7:642-5.
2. Wheeler P. The loss of functional body hair in man: the influence of thermal environment, body form and bipedality. J Hum Evol. 1985;14:23-8.
3. Hadshiew I, Foitzick K, Arck P. Burden of hair loss: stress and the underestimated psychosocial impact of telogen effluvium and androgenetic alopecia. J Invest Dermatol. 2004;123:455-7.
4. Hunt N, McHale S. The psychological impact of alopecia. BMJ. 2005;331:951-3.
5. Girman CJ, Rhodes T, Lilly FRW. Effects of self-perceived hair loss in a community simple of men. Dermatology. 1998;197:223-9.
6. Blanpain C, Fuchs E. Epidermal stem cells of the skin. Annu Rev Cell Dev Biol. 2006;22:339-73.
7. Aznar Benitah S. Epidermal stem cells in skin homeostasis and cutaneous carcinomas. Clin Transl Oncol. 2007;9:760-6.
8. Paus R, Cotsarelis G. The biology of hair follicles. N Engl J Med. 1999;341:491-7.
9. Deedrick D, Koch S. Microscopy of hair. Part 1: A practical guide and manual for human hairs. Forensic Science Communications, 2004;6. Fecha de consulta: 19 de junio de 2010. Disponible en: jan2004/research/2004_01_research01b.htm.
10. Olsen E. Clinical tools for assessing hair loss. In: Olsen E, editor. Disorders of hair growth diagnosis and treatment. Second edition. New York: McGraw-Hill: 2003. p. 75-85.
11. Restrepo R. Cortes transversales vs. verticales para el diagnóstico de las alopecias. Rev Asoc Colomb Dermatol. 2008;16:23-28.
12. Elston DM, Ferringer T, Dalton S, Fillman E, Tyler W. A comparison of vertical versus transverse sections in the evaluation of alopecia biopsy specimens. J Am Acad Dermatol. 2005;53:267-72.
13. Flotte TJ. Transverse sectioning of the scalp (Headington technique) in the 19th century. J Cutan Pathol. 2008;35:82-5.
14. Böer A, Hoene K. Transverse sections for diagnosis of alopecia? Am J Dermatopathol. 2005;27:348-52.
15. Garcia C, Poletti E. Scalp biopsy specimens: transverse vs vertical sections. Arch Dermatol. 2007;143:268.
16. Schmidt-Ullrich R, Paus R. Molecular principles of hair follicle induction and morphogenesis. Bioessays. 2005;27:247- 261
17. Hardy MH. The secret life of the hair follicle. Trends Genet. 1992;8:55-61.
18. Billinghan RE. A reconsideration of the phenomenon of hair neogenesis with particular reference to the healing of cutaneous wounds in adult mammals. In: Montagna W, Ellis RA, editors. The biology of hair growth. New York: Academic Press: 1958. p 451.
19. Millar SE. Molecular mechanisms regulating hair follicle development. J Invest Dermatol. 2002;118:216-25.
20. Blanpain C, Fuchs E. Epidermal stem cells of the skin. Annu Rev Cell Dev Biol. 2006;22:339-73.
21. Millar SE. Molecular mechanisms regulating hair follicle development. J Invest Dermatol. 2002;118:216-25.
22. Gat U, DasGupta R, Degenstein L. De novo hair follicle morphogenesis and hair tumors in mice expressing a truncated beta-catenin in skin. Cell. 1998;95:605-14.
23. Chan EF, Gat U, McNiff JM. A common human skin tumour is caused by activating mutations in beta-catenin. Nat Genet. 1999;21:410-3.
24. Kere J, Srivastava AK, Montonen O. X-linked anhidrotic (hypohidrotic) ectodermal dysplasia is caused by mutation in a novel transmembrane protein. Nat Genet. 1996;13:409-16.
25. Kaufman CK. GATA-3. An unexpected regulator of cell lineage determination in skin. Genes Dev. 2003;17:2108-22.
26. Noramly S, Morgan BA. BMPs mediate lateral inhibition at successive stages in feather tract development. Development. 1998;125:3775-87.
27. Szabo G. The regional anatomy of the human integument with special reference to the distribution of hair follicles, sweat glands and melanocytes. Philos Trans R Soc Lond, Serie B, Bol Sci. 1967:252:447-85.
28. Headington JT. Transverse microscopic anatomy of human scalp. Arch Dermatol. 1984;120:449-56.
29. Sperling LC. Hair anatomy for the clinician. J Am Acad Dermatol. 1991;25:1-7.
30. Poblet E, Ortega F, Jiménez F. The arrector pili muscle and the follicular unit of the scalp: a microscopic anatomy study. Dermatol Surg. 2002;28:800-3.
31. Parry DA, Smith TA, Rogers MA. Human hair keratin-associated proteins: sequence regularities and structural implications. J Struct Biol. 2006;155:361-9.
32. Wolfram L. Human hair: a unique physicochemical composite. J Am Acad Dermatol. 2003;48:S106-14
33. Whiting DA. Hair and nail histology. In: Hordinsky MK, Sawaya ME, Scher RK, editors. Atlas of hair and nails. Edinburgh: Churchill Livingstone; 2000. p. 9-23.
34. Horenstein MG, Simon J. Investigation of the hair follicle inner root sheath in scarring and non-scarring alopecia. J Cutan Pathol. 2007;34:762-8.
35. Sundberg JP, Boggess D, Sundberg BA. Asebia-2J (Scd1(ab2J)): a new allele and a model for scarring alopecia. Am J Pathol. 2000;156:2067-75.
36. Krause K, Foitzik K. Biology of the hair follicle: the basics. Semin Cutan Med Surg. 2006;25:2-10.
37. Peters EM, Hansen MG, Overall RW. Control of human hair growth by neurotrophins: brain-derived neurotrophic factor inhibits hair shaft elongation, induces catagen, and stimulates follicular transforming growth factor beta2 expression. J Invest Dermatol. 2005;124:675-85.
38. Paus R, Foitzik K. In search of the "hair cycle clock": a guided tour. Differentiation. 2004;72:489-511.
39. Myers RJ, Hamilton JB. Regeneration and rate of growth of hairs in man. Ann NY Acad Sci. 1951;53:562-8.
40. Slominski A, Wortsman J, Plonka PM. Hair follicle pigmentation. J Invest Dermatol. 2005;124:13-21.
41. van Neste D, Tobin DJ. 2004 Hair cycle and hair pigmentation: dynamic interactions and changes associated with aging. Micron. 2004;35:193-200.
42. Commo S, Gaillard O, Bernard BA. Human hair greying is linked to a specific depletion of hair follicle melanocytes affecting both the bulb and the outer root sheath. Br J Dermatol. 2004;150:435-43.
43. Tobin DJ. A possible role for Langerhans cells in the removal of melanin from early catagen hair follicles. Br J Dermatol. 2003;138:795-8.
44. Bergfeld W, Mulinari-Brenner F, McCarron K. The combined utilization of clinical and histological findings in the diagnosis of trichotillomania. J Cutan Pathol. 2002;29:207-14.
45. Muller SA. Trichotillomania: a histopathologic study in sixty-six patients. J Am Acad Dermatol. 1990;23:56-62.
46. Cotsarelis G. Epithelial stem cells: A folliculocentric view. J Invest Dermato. 2006;126:1459-68.
47. Ohyama M. Hair follicle bulge: a fascinating reservoir of epithelial stem cells. J Dermatol Sci. 2007;46:81-9.
48. Narisawa EK, Jordan SA, Oshima H. Dominant role of the niche in melanocyte stem-cell fate determination. Nature. 2002;416:854-60.
49. Lako M, Armstrong L, Cairns PM. Hair follicle dermal cells repopulate the mouse haematopoietic system. J Cell Sci. 2002;115:3967-74.
50. Kumamoto T, Shalhevet D, Matsue H. Hair follicles serve as local reservoirs ok skin mast cell precursors. Blood. 2003;102:1654-60.
51. Mobini N, Tam S, Kamino H. Possible role of the bulge region in the pathogenesis of inflammatory scarring alopecia: lichen planopilaris as the prototype. J Cutan Pathol. 2005:32:675-9.
52. Pozdnyakova O, Mahalingam M. Involvement of the bulge region in primary scarring alopecia. J Cutan Pathol. 2008;35:922-5.
53. Harries MJ, Meyer KC, Paus R. Hair loss as a result of cutaneous autoimmunity: Frontiers in the immunopathogenesis of primary cicatricial alopecia. Autoimmun Rev. 2009;8:478-83.
54. van Neste D, Leroy T, Conil S. Exogen hair characterization in human scalp. Skin Res Technol. 2007;13:436-43.
55. Rebora A, Guarrera M. Teloptosis and kenogen: two new concepts in human trichology. Arch Dermatol. 2004;140:619-20.
56. Rebora A, Guarrera M. Kenogen. A new phase of the hair cycle? Dermatology. 2002;205:108-10.
57. Guarrera M, Rebora A. Kenogen in female androgenetic alopecia. A longitudinal study. Dermatology. 2005;210:18-20.
58. Messenger AG, Sinclair R. Follicular miniaturization in female pattern hair loss: clinicopathological correlations. Br J Dermatol. 2006;155:926-30.
59. Thomas JA, Biggerstaff M, Sloane JP. Immunological and histochemical analysis of regional variations of epidermal Langerhans cells in normal human skin. Histochem J. 1984;16:507-19.
60. Christoph T, Muller-Rover S, Audring H. The human hair follicle immune system, cellular composition and immune privilege. Br J Dermatol. 2000;142:862-73.
61. Paus R, Nickoloff BJ, Ito T. A 'hairy' privilege. Trends Immunol. 2005;26:32-40.
62. Ito T, Ito N, Saatoff M. Maintenance of hair follicle immune privilege is linked to prevention of NK cell attack. J Invest Dermatol. 2008;128:1196-206.
63. Ito T, Meyer KC, Ito N. Immune privilege and the skin. Curr Dir Autoimmun. 2008;10:27-52.
64. Price VH. Plenary workshop on alopecia areata. J Invest Dermatol Symp Proc. 2005;10:280-5
65. Whiting DA, Dy LC. Office diagnosis of hair shaft defects. Semin Cutan Med Surg. 2006;25:24-34.
66. Shelley WB. Hair examination using double-stick tape. J Am Acad Dermatol. 1983;8:430-1.
67. Zitelli JA. Pseudomonilethrix. An artifact. Arch Dermatol. 1986;122:688-90.
68. Baden,HP, Kubilus J, Baden L. A stain for plucked anagen hairs. J Am Acad Dermatol. 1979;1:121-2.
69. Piérard GE, Piérard-Franchimont C, Marks R, Elsner P, EEMCO group (European Expert Group on Efficacy Measurement of Cosmetics and other Topical Products). EEMCO guidance for the assessment of hair shedding and alopecia. Skin Pharmacol Physiol. 2004;17:98-110.
70. Olsen EA, Bettencourt MS, Coté NL. The presence of loose anagen hairs obtained by hair pull in the normal population. J Investig Dermatol Symp Proc. 1999;4:258-60.
71. Franbourg A, Hallegot P, Baltenneck F. Current research on ethnic hair. J Am Acad Dermatol. 2003;48:S115-9.
72. Wolfram LJ. Human hair: a unique physicochemical composite. J Am Acad Dermatol. 2003;48:S106-14.
73. McMichael AJ. Ethnic hair update: past and present. J Am Acad Dermatol. 2003;48:S127-33.
74. Lee HJ, Ha SJ, Lee JH. Hair counts from scalp biopsy specimens in Asians. J Am Acad Dermatol. 2002;46:218-21.
75. Sperling LC. Hair density in African Americans. Arch Dermatol. 1999;135:656-8.
76. Mangelsdorf S, Otberg N, Maibach HI. Ethnic variation in vellus hair follicle size and distribution. Skin Pharmacol Physiol. 2006;19:159-67.
Cómo citar
Restrepo R. Anatomía microscópica del folículo piloso. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 26 de febrero de 2019 [citado 22 de junio de 2021];18(3):123-38. Disponible en:


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