Role of dermoscopy in the diagnosis of alopecia
Keywords:
Dermoscopy, alopecia areata, pili bifurcati, androgenetic alopecia, telogen effluvium, lichen planopilaris, discoid lupus erythematosusAbstract
Objective The aim of the study was to evaluate the dermoscopic findings in various types of  alopecia. Methods A total of 100 patients presenting with alopecia were subjected to dermoscopy with a videodermoscope of magnification 50X and 200X. Results Among 100 patients studied, 21 had alopecia areata (AA), 38 had male androgenetic alopecia (MAGA), nine had female androgenetic alopecia (FAGA), 27 had telogen effluvium (TE), and five had cicatricial alopecia. The most common dermoscopic findings observed in AA were black dots (76%), short vellus hairs (71%) and broken hairs (67%). More than 20% hair diameter diversity (HDD) was observed in the affected areas of all male and female AGA cases. Pigment incontinence, follicular keratotic plugging and follicular effacement were seen in both discoid lupus erythematosus (DLE) and lichen planopilaris (LPP). The characteristic dermoscopic findings in DLE were red dots and arborising red lines. Peripilar cast was the specific finding for LPP. Conclusion Each type of alopecia has unique dermoscopic findings and this facilitates the diagnosis of alopecia. Pili bifurcati like finding was noted in AA.ÂReferences
Hu R, Xu F, Han Y, Sheng Y, Qi S, Miao Y, Yang Q. Trichoscopic findings of androgenetic alopecia and their association with disease severity. J Dermatol. 2015;42:602-7.
Tosti A. Hair shaft disorders. In: Tosti A, editor. Dermoscopy of Hair and Scalp: Pathological and Clinical Correlation. Illustrated ed. Philadelphia: CRC Press; 2007. p. 51-3.
Abedini R, KamyabHesari K, Daneshpazhooh M, Ansari MS, Tohidinik HR, Ansari M. Validity of trichoscopy in the diagnosis of primary cicatricial alopecias. Int J Dermatol. 2016;55:1106-14.
Jain N, Doshi B, Khopkar U. Trichoscopy in alopecias: Diagnosis simplified. Int J Trichol. 2013;5:170-8.
Ross EK, Vincenzi C, Tosti A. Videodermoscopy in the evaluation of hair and scalp disorders. J Am Acad Dermatol. 2006;55:799-806.
Inui S, Nakajima T, Nakagawa K, Itami S. Clinical significance of dermoscopy in alopecia areata: Analysis of 300 cases. In J Dermatol. 2008;47:688-93.
Mane M, Nath AK, Thappa DM. Utility of dermoscopy in alopecia areata. Indian J Dermatol. 2011;56:407-11.
Hegde SP, Naveen KN, Athanikar SB, Reshme P. Clinical and dermatoscopic patterns of alopecia areata: A tertiary care centre experience. Int J Trichol. 2013;5:132-6.
Bapu NG, Chandrashekar L, Munisamy M, Thappa DM, Mohanan S. Dermoscopic findings of alopecia areata in dark skinned individuals: An analysis of 116 cases. Int J Trichol. 2014;6:156-9.
Rudnicka L, Olszewska M, Rakowska A, Slowinska M. Trichoscopy update 2011. J Dermatol Case Rep. 2011;5:82-8.
Lacarrubba F, Dall’Oglio F, Rita Nasca M, Micali G. Videodermatoscopy enhances diagnostic capability in some forms of hair loss. Am J Clin Dermatol. 2004;5:205-8.
Miteva M, Tosti A. Hair and scalp dermatoscopy. J Am Acad Dermatol. 2012;65:91-8.
Franciso M. Camacho-Martinez. Hair loss in women. Semin Cutan Med Surg. 2009;28:19-32.
Sewell LD, Elston DM, Dorion RP. “Anisotrichosisâ€: a novel term to describe pattern alopecia. J Am Acad Dermatol. 2007;56:856.
De Lacharrière O, Deloche C, Misciali C, Piraccini BM, Vincenzi C, Bastien P et al. Hair diameter diversity: A clinical sign reflecting the follicle miniaturization. Arch Dermatol. 2001; 137:641 6.
Inui S, Nakajima T, Itami S. Scalp dermoscopy of androgenetic alopecia in Asian people. J Dermatol. 2009;36:82-5.
Deloche C, de Lacharriere O, Misciali C, Piraccini BM, Vincenzi C, Bastien P et al. Histological features of peripilar signs associated with androgenetic alopecia. Arch Dermatol Res. 2004;295:422-8.
Pierard-Franchimont C, Xhauflaire-Uhoda E, Loussouarn G, Saint Léger D, Piérard GE. Dandruff-associated smouldering alopecia: a chronobiological assessment over 5 years. Clin Exp Dermatol. 2006;31:23-6.
Braun RP, Rabinovitz HS, Oliviero M, Kopf AW, Saurat JH. Dermoscopy of pigmented skin lesions. J Am Acad Dermatol. 2005;52:109-21.
Gilmore S, Sinclair R. Chronic telogen effluvium is due to a reduction in the variance of anagen duration. Australas J Dermatol. 2010;51:163-7.
Rakowska A, Slowinska M, Kowalska Oledzka E, Warszawik O, Czuwara J, Olszewska M et al. Trichoscopy of cicatricial alopecia. J Drugs Dermatol. 2012;11:753-8.
Tosti A, Torres F, Misciali C, Vincenzi C, Starace M, Miteva M et al. Follicular red dots: A novel dermoscopic pattern observed in scalp discoid lupus erythematosus. Arch Dermatol. 2009;145:1406-9.
Qi S, Zhao Y, Zhang X, Li S, Cao H, Zhang X. Clinical features of primary cicatricial alopecia in Chinese patients. Indian J Dermatol Venereol Leprol. 2014;80:306-12.
Thakur BK, Verma S, Raphael V. Clinical, trichoscopic, and histopathological features of primary cicatricial alopecias: A retrospective observational study at a tertiary care centre of North East India. Int J Trichol. 2015;7:107-12.
