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It is a curious phenomenon that lesions of acne vulgaris develop on the forehead, face, interscapular and sternal regions, shoulders, chest, dorsum and trunk, but never on the scalp. At first thought, it would seem that the skin of the scalp offers an ideal site for the development of acne vulgaris, since it abounds in sebaceous glands. A review of the pertinent literature, however, failed to reveal an explanation or even an attempt at explanation of this interesting phenomenon. My explanation, therefore, is presented herewith.
It would seem that the utmost importance should be attached to the peculiar histologic structure of sebaceous glands and hairs in various parts of the body. The skin of the scalp reveals a well developed hair follicle and beside it a sebaceous gland. This gland empties its contents into the hair follicle at its neck, namely, at the junction of the middle and the upper
BREGMAN A. NEW CONCEPTIONS OF THE ETIOLOGY AND PATHOGENESIS OF ACNE VULGARIS. Arch Derm Syphilol. 1937;36(4):758–759. doi:10.1001/archderm.1937.01480040075005
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