Bacterial profiling of the scalp surface of healthy subjects and alopecia patients. (a) Community composition of the scalp surface of healthy subjects and alopecia patients at the Genus level. Relative abundance (%) of the most abundant bacteria collected from scalp swabs, sampled from frontal (F) and occipital (O) scalps in healthy or lesional (L) and non-lesional (NL) scalp regions in patients. H (n = 12), AAc (n = 6), LPP (n = 6), FFA (n = 6). (b) Representative images at the level of HF infundibulum. Gram staining and HβD1 expression in paraffin-embedded sections of healthy scalp, and lesional scalp of cicatricial alopecia patients, assessed by immunohistochemistry. Magnification for Gram images × 400, bar scale = 20 μm, and for HβD1 images × 100, bar scale = 100 μm, respectively. (c) Semi-quantitative analysis of bacteria presence and the expression of HβD1 antimicrobial peptide at the level of infundibulum verifies the strong microbial colonization in HF openings and scalp surface. H (n = 3), LPP (n = 8), FFA (n = 7). H, healthy; FFA, frontal fibrosing alopecia; LPP, lichen planopilaris; AAc, alopecia areata circumscripta; HF, hair follicle.