Cicatricial alopecia: do clinical, trichoscopic, and histopathological diagnosis agree?

Bary, Amany Abdel; Eldeeb, Marwa; Hassan, Ekram M.

doi:10.15570/actaapa.2021.32

Cited by 2 publications

(2 citation statements)

References 31 publications

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“…Even though histopathology (sensitivity of 40%, 70% for LPP, DLE respectively and specificity of 92%, 63% for LPP, DLE respectively) and direct immunofluorescence (sensitivity of 34%, 83% for LPP, DLE respectively, and a specificity of 95%, 93% for LPP, DLE respectively) are considered the important diagnostic, trichoscopy can be utilized to diagnose scalp pathology and as a prognostic tool during follow-up. [3][4][5][6] The most common PCA encountered is LPP. 7 It usually clinically presents as violaceous papules, which are replaced with follicular plugs and scarring.…”

Section: Introductionmentioning

confidence: 99%

Trichoscopic Features of Scalp Discoid Lupus Erythematosus versus Lichen Planopilaris: A Systematic Review

Gowda,

Errichetti,

Thakur

et al. 2024

CCID

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Lichen planopilaris (LPP) and discoid lupus erythematosus (DLE) are primary scarring alopecias that pose diagnostic challenges clinically, where trichoscopy features may provide benefit in delineating these two cicatricial alopecia, and also helps in assessing the evolution and therapeutic response. To date, there are few reviews on dermoscopic findings in differentiating these two alopecias. Methods: A systematic literature review was conducted using the PubMed and Google Scholar databases. The search terms included for scalp DLE were 'lupus' OR 'discoid lupus' OR "scalp lupus" and for scalp LPP were "lichen planopilaris" OR "scalp follicular lichen planus" OR "lichen planus follicularis" and were combined with "dermoscopy" OR "dermatoscopy" OR "videodermoscopy" OR "video dermatoscopy" OR "trichoscopy". The differences in the prevalence of dermoscopic features in scalp DLE and LPP were calculated using the Chi-square test. Results: Of 52 articles, 36 (17 LPP, 19 DLE) were eligible for quantitative analysis. We found predominant peripilar tubular casts and perifollicular erythema with the presence of arborizing vessels in the vicinity of these changes, indicating early LPP. In contrast, follicular red dots, speckled brown pigmentation, and hair diameter variability indicated active DLE. Shiny white areas were common in both the groups in late stages. The target pattern of distribution of blue-grey dots, milky red areas, and irregular white fibrotic dots were seen in LPP, and pink-white background, follicular plugs, perifollicular and interfollicular scale, rosettes, chrysalides, and red spider on yellow dots were detected in DLE. Features such as yellow dots and blue-grey structureless areas were nonspecific and did not have a major role in differentiating DLE from LPP. Conclusion:This article provides a comprehensive review of the literature and delineates the trichoscopic differences and peculiarities of scalp DLE and LPP, including the correlation of dermoscopic features with histopathological findings.

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Section: Introductionmentioning

confidence: 99%

Trichoscopic Features of Scalp Discoid Lupus Erythematosus versus Lichen Planopilaris: A Systematic Review

Gowda,

Errichetti,

Thakur

et al. 2024

CCID

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“…This is due to the heterogeneity of the clinical, dermatoscopic, and histologic presentation, which makes it difficult to differentiate LE from other forms of scarring alopecia like lichen planopilaris (LPP), which can present clinical and histological mimicry. 7 , 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Line‐field confocal optical coherence tomography: Characteristic hints for the diagnosis of scarring alopecia due to lupus erythematodes: A preliminary study

Nutz,

Deußing,

Hartmann

et al. 2024

Skin Research and Technology

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IntroductionLupus erythematosus (LE) is an inflammatory autoimmune disease, that can affect the skin to varying degree. In particular, discoid LE (DLE) and the rare form of lupus panniculitis/profundus are associated with scarring alopecia. The heterogeneity of the clinical, dermatoscopic, and histologic presentation poses a major challenge to the clinician in the diagnosis and differential diagnosis of other forms of scarring alopecia.ObjectiveWhile noninvasive imaging techniques using optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) have proven to be helpful in the diagnosis of scarring alopecia in the context of LE, this study aimed to investigate line‐field confocal OCT (LC‐OCT) to identify characteristic features of cicatricial alopecia in LE.MethodsFifteen patients with cicatricial alopecia in LE were included and the most affected/inflamed areas of the scalp were prospectively examined. In analogy to histopathology and previously reported criteria in RCM, all images were evaluated according to seven established criteria and underwent descriptive analyses.ResultsLC‐OCT revealed characteristic features of cicatricial alopecia, such as lymphocytic interface dermatitis (14/15; 93.3%) and basal cell vacuolization (13/15; 86.7%). The most impressive feature was the occurrence of prominent hyperreflective fibers in 14/15 patients (93.3%).ConclusionLC‐OCT imaging can noninvasively detect morphologic criteria such as lymphocytic and vacuolar interface dermatitis of cicatricial alopecia due to LE. In particular, the presence of hyperreflective collagen fibers appears to be a characteristic easily recognizable feature that may facilitate differential diagnosis with other forms of cicatricial alopecia. Further studies are mandatory to differentiate other forms of scarring alopecia.

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Cicatricial alopecia: do clinical, trichoscopic, and histopathological diagnosis agree?

Cited by 2 publications

References 31 publications

Trichoscopic Features of Scalp Discoid Lupus Erythematosus versus Lichen Planopilaris: A Systematic Review

Trichoscopic Features of Scalp Discoid Lupus Erythematosus versus Lichen Planopilaris: A Systematic Review

Line‐field confocal optical coherence tomography: Characteristic hints for the diagnosis of scarring alopecia due to lupus erythematodes: A preliminary study

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