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Yet, surprisingly, scalp psoriasis only rarely causes alopecia, even though the pilosebaceous unit clearly is affected. Here, we systematically explore the peculiar, insufficiently investigated connection between psoriasis and growing (anagen) terminal scalp hair follicles (HFs), with emphasis on shared regulatory mechanism and therapeutic targets. Interestingly, several drugs and stressors that can <jats:italic>trigger<\/jats:italic>\/<jats:italic>aggravate<\/jats:italic> psoriasis can <jats:italic>inhibit<\/jats:italic> hair growth (e.g. beta\u2010blockers, chloroquine, carbamazepine, interferon\u2010alpha, perceived stress). Instead, several anti\u2010psoriatic agents can stimulate hair growth (e.g. cyclosporine, glucocorticoids, dithranol, UV irradiation), while skin\/HF trauma (K\u00f6bner phenomenon\/depilation) favours the development of psoriatic lesions and induces anagen in \u201cquiescent\u201d (telogen) HFs. On this basis, we propose two interconnected working models: (a) the existence of a bidirectional \u201chair follicle\u2010psoriasis axis,\u201d along which keratinocytes of anagen scalp HFs secrete signals that favour the development and maintenance of psoriatic scalp lesions and respond to signals from these lesions, and (b) that anagen induction and psoriatic lesions share molecular \u201cswitch\u2010on\u201d mechanisms, which invite pharmacological targeting, once identified. Therefore, we advocate a novel, cross\u2010fertilizing and integrative approach to psoriasis and hair research that systematically characterizes the \u201cHF\u2010psoriasis axis,\u201d focused on identification and therapeutic targeting of selected, shared signalling pathways in the future management of both, psoriasis and hair growth disorders.<\/jats:p>","DOI":"10.1111\/exd.14462","type":"journal-article","created":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T21:30:44Z","timestamp":1632951044000},"page":"266-279","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The hair follicle\u2010psoriasis axis: Shared regulatory mechanisms and therapeutic targets"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6012-0229","authenticated-orcid":false,"given":"Takahiro","family":"Suzuki","sequence":"first","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology &amp; Cutaneous Surgery University of Miami Miller School of Medicine Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9274-7050","authenticated-orcid":false,"given":"Taisuke","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4267-2986","authenticated-orcid":false,"given":"Amos","family":"Gilhar","sequence":"additional","affiliation":[{"name":"Skin Research Laboratory Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Tokura","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan"},{"name":"Allergic Disease Research Center Chutoen General Medical Center Kakegawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Reich","sequence":"additional","affiliation":[{"name":"Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Monasterium Laboratory M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Paus","sequence":"additional","affiliation":[{"name":"Dr. Phillip Frost Department of Dermatology &amp; 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