The diagnostic value of trichoscopy in systemic sclerosis

Kwiatkowska, Małgorzata; Rakowska, Adriana; Walecka, Irena; Rudnicka, Lidia

doi:10.3315/jdcr.v10i2.1937

Cited by 2 publications

(6 citation statements)

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“…Nevertheless, although telangiectasias are common in SLE, they are also detected on the scalp of patients with other autoimmune connective tissue diseases, including systemic sclerosis 20 and dermatomyositis. 21 A challenging concept would be to study the differences in scalp telangiectasia morphology between different autoimmune connective tissue diseases.…”

Section: Discussionmentioning

confidence: 99%

Nonscarring alopecia in systemic lupus erythematosus: A cross-sectional study with trichoscopic, histopathologic, and immunopathologic analyses

Chanprapaph

Udompanich

Visessiri

et al. 2019

Journal of the American Academy of Dermatology

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Background: Nonscarring alopecia in systemic lupus erythematosus (SLE) is widely recognized, but reports on its clinical, trichoscopic, histopathologic, and direct immunofluorescence (DIF) features are still limited.Objective: To summarize the different clinical patterns, trichoscopic, histopathologic, and DIF features of nonscarring alopecia in SLE and to prove its association with disease activity.Methods: Patients with SLE with and without nonscarring alopecia had full physical/trichoscopic examination and scalp biopsy. Their disease activity scores and laboratory data were evaluated and statistically analyzed.Results: Thirty-two patients with SLE had different patterns of nonscarring alopecia, including mild diffuse alopecia (43.8% [n = 14]), severe diffuse alopecia (15.6% [n = 5]), patchy alopecia (28.1% [n = 9]), and lupus hair (12.5% [n = 4]). The most common trichoscopic findings were arborizing/interconnecting vessels (83% [n = 26]). Histopathologic examination showed interface changes along the dermoepidermal junction (87.5% [n = 28]) and follicular epithelium (40.6% [n = 13]). On DIF, homogeneous granular deposition was detected along the dermoepidermal junction (78.1% [n = 25]) and follicular epithelium (78.1% [n = 25]). When compared with 10 patients with SLE without alopecia, there was a significantly higher SLE Disease Activity Index 2000 score and prevalence of proteinuria ([1 g/d).Limitations: This was a small, cross-sectional, single-center study.Conclusions: Nonscarring alopecia in SLE shows lupus erythematosusespecific changes on histology and DIF. Hair loss in SLE can be considered as an indicator of active disease.

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Section: Discussionmentioning

confidence: 99%

Nonscarring alopecia in systemic lupus erythematosus: A cross-sectional study with trichoscopic, histopathologic, and immunopathologic analyses

Chanprapaph

Udompanich

Visessiri

et al. 2019

Journal of the American Academy of Dermatology

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“…Characteristics of arborizing vessels were described as thin arborizing blood vessels (vessel diameter thinner than that of terminal hair shafts), prominent arborizing blood vessels (thin vessels forming a vascular network), and thick arborizing blood vessels (vessel diameter larger than that of terminal hair shafts) [19, 32, 33]. Other distinctive vascular patterns, including microaneurysmal blood vessel (linear, serpentine, or tortuous dilated capillary with an ectatic portion resembling an aneurysm), dotted vessels, hairpin vessels, and polymorphic vessels forming a telangiectatic network (PVTN; different pattern of vessels forming a network of telangiectasia), were documented [20, 32]. Finally, avascular areas (whitish areas of fibrosis with the absence of blood vessels) were evaluated [20].…”

Section: Methodsmentioning

confidence: 99%

“…Other distinctive vascular patterns, including microaneurysmal blood vessel (linear, serpentine, or tortuous dilated capillary with an ectatic portion resembling an aneurysm), dotted vessels, hairpin vessels, and polymorphic vessels forming a telangiectatic network (PVTN; different pattern of vessels forming a network of telangiectasia), were documented [20, 32]. Finally, avascular areas (whitish areas of fibrosis with the absence of blood vessels) were evaluated [20]. All trichoscopic photographs taken were assessed by one blinded hair specialist.…”

Section: Methodsmentioning

confidence: 99%

“…Data analyses were performed using Stata 14.0 (Stata Corp. LLC, College Station, TX, USA). The sample size was estimated based on data from previous studies regarding trichoscopy of CTDs, and a minimum of 26 subjects per group was required [7, 19, 20]. Categorical variables were expressed as counts and percentages.…”

Section: Methodsmentioning

confidence: 99%

“…Although trichoscopy may provide diagnostic clues for CTDs, only a few studies have exhibited this information [7, 19, 20]. A direct comparison of the trichoscopic findings among the most common CTDs, namely DM, SLE, and SSc, and their relations to the disease activity is lacking.…”

Section: Introductionmentioning

confidence: 99%

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Trichoscopic Signs in Dermatomyositis, Systemic Lupus Erythematosus, and Systemic Sclerosis: A Comparative Study of 150 Patients

et al. 2021

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Background: Hair and scalp involvement is prevalent in connective tissue diseases (CTDs). Trichoscopic features may provide a diagnostic implementation and enable differentiation among CTDs; however, a direct comparison of these signs among CTD patients is lacking. Objectives: To compare trichoscopic findings in dermatomyositis (DM), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc) as well as determine their distinctive features and associations with disease activity. Methods: Trichoscopic photographs were taken from DM, SLE, and SSc patients and further evaluated for hair shaft and scalp surface abnormalities. Data regarding patients’ clinical manifestations, laboratory results, and disease activity were analyzed. Results: One hundred fifty participants, consisting of 30 DM, 60 SLE, and 60 SSc patients, were included. Perifollicular red-brown pigmentation, brown scattered pigmentation, and white patches were exclusive findings in DM, SLE, and SSc, respectively (p < 0.001). A multinomial logistic regression analysis revealed that DM demonstrated higher odds for having microaneurysmal blood vessels than SLE and SSc (odds ratio [OR] = 22.22, 95% confidence interval [CI] = 1.73–285.13, p = 0.017, and OR = 15.34, 95% CI = 1.36–177.59, p = 0.029, respectively). Polymorphic vessels forming a telangiectatic network suggested SSc over SLE (OR = 12.83, 95% CI = 1.35–121.98, p = 0.026), while avascular areas were more pronounced in SSc than DM and SLE (OR = 43.24, 95% CI = 5.17–361.67, p = 0.001, and OR = 0.03, 95% CI = 0.01–0.24, p = 0.001, respectively). In a quantile regression analysis, perifollicular red-brown pigmentation, reduction in hair diameter, and the absence of thin arborizing vessels were linked to higher disease activity in DM, SLE, and SSc, respectively (all p < 0.05). Conclusions: Trichoscopy is a valuable tool possessing diagnostic and prognostic values for CTDs. Specific trichoscopic features allow adequate distinction between DM, SLE, and SSc and may help identify active disease.

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The diagnostic value of trichoscopy in systemic sclerosis

Cited by 2 publications

References 6 publications

Nonscarring alopecia in systemic lupus erythematosus: A cross-sectional study with trichoscopic, histopathologic, and immunopathologic analyses

Nonscarring alopecia in systemic lupus erythematosus: A cross-sectional study with trichoscopic, histopathologic, and immunopathologic analyses

Trichoscopic Signs in Dermatomyositis, Systemic Lupus Erythematosus, and Systemic Sclerosis: A Comparative Study of 150 Patients

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