Different Trichoscopic Features of Tinea Capitis and Alopecia Areata in Pediatric Patients

Abstract

Background. Diagnosis of patchy hair loss in pediatric patients is often a matter of considerable debate among dermatologists. Trichoscopy is a rapid and noninvasive tool to detect more details of patchy hair loss. Like clinical dermatology, trichoscopy works parallel to the skin surface and perpendicular to the histological plane; like the histopathology, it thus allows the viewing of structures not discovered by the naked eye. Objective. Aiming to compare the different trichoscopic features of tinea capitis and alopecia areata in pediatric patients. Patients and Methods. This study included 40 patients, 20 patients with tinea capitis and 20 patients with alopecia areata. They were exposed toclinical examination, laboratory investigations (10% KOH and fungal culture), and trichoscope examination. Results. Our obtained results reported that, in tinea capitis patients, comma shaped hairs, corkscrew hairs, and zigzag shaped hairs are the diagnostic trichoscopic features of tinea capitis. While in alopecia areata patients, the most trichoscopic specific features were yellow dots, exclamation mark, and short vellus hairs. Conclusion. Trichoscopy can be used as a noninvasive tool for rapid diagnosis of tinea capitis and alopecia areata in pediatric patients.

Trichoscopy of alopecia areata: An update

“…Differences in the reported frequency of this trichoscopic finding may be attributed to skin phototypes (it has been hypothesized that yellow dots are generally less visible in populations with yellowish or dark color of the skin), type of dermoscopy device, as well as different shampooing habits between European, Asian and Latin American cultures . However, the highest prevalence of yellow dots was reported in studies conducted in dark‐skinned patients (phototype V according to Fitzpatrick's scale), ranging 6–100% (mean value, 72%) with a handheld dermoscope and 69–82% (mean value, 77%) with a videodermoscope . On the contrary, yellow dots in white‐skinned patients (phototype I–III according to Fitzpatrick's scale) were observed in 81% with a dermoscope and 13–95% (mean value, 50%) with a videodermoscope .…”

“…However, it is also present in the acute form of alopecia areata . Yellow dots were observed in 6–100% (mean value, 62%) of patients with alopecia areata . Differences in the reported frequency of this trichoscopic finding may be attributed to skin phototypes (it has been hypothesized that yellow dots are generally less visible in populations with yellowish or dark color of the skin), type of dermoscopy device, as well as different shampooing habits between European, Asian and Latin American cultures .…”

“… The ranges from published articles are given for the trichoscopic features for which the frequency was evaluated. ‡ Mean value was calculated by dividing the total number of patients with a particular feature by the total number of patients in studies reporting the frequency of this feature. …”

Trichoscopy of Focal Alopecia in Children - New Trichoscopic Findings: Hair Bulbs Arranged Radially along Hair-Bearing Margins in Aplasia Cutis Congenita

“…The procedure can easily confirm alopecia areata due to its particular trichoscopic features: exclamation mark hairs, yellow and black dots, and caudability hairs [3]. The trichoscopic features of trichotillomania in adult patients (flame hairs, tulip hairs, coiled hairs, hook hais, v-sign and irregularly broken hairs) have been described [4,5], while the characteristic findings in tinea capitis (comma hairs, zigzag hairs, corkscrew hairs and block hairs) have also been documented [6,7]. To the best of our knowledge, there is only one description referring to the trichoscopy of ACC [8].…”

Infections, Infestations and Neoplasms of the Scalp

“…Trichoscopy is an additional tool for the diagnosis of tinea capitis. Comma shaped hairs, corkscrew hairs and zigzag shaped hairs are the diagnostic trichoscopic features of tinea capitis [40,41]. Skin biopsy can be done for differential diagnosis.…”