The role of scalp dermoscopy in the diagnosis of alopecia areata incognita

A importância do exame tricológico no diagnóstico da alopecia areata

“…2 Inui et al and Tosti et al were the first to publish papers on AA dermoscopic findings. 4,[7][8][9] Dermoscopy reveals the following in the initial phase of AA:…”

“…Exclamation-point hairs: thinner and less pigmented at the base, thicker and more pigmented at the distal end (Figure 1), [1][2][3]5,7,8 occurring more frequently at the periphery of the plaque, and indicating disease activity. 4,5,9 Exclamation point hairs can also be spindle-like, similar to those found in cases of beaded hair (monilethrix).…”

“…4,7,9,10 Hair bendability or 'elbow sign' (Coudability-coudé): typical of apparently normal hair which, due to keratinization changes, has a fragile shaft and folds easily on itself when spread or pushed along its axis toward the scalp. 1 Trichoptilosis: longitudinal splitting of the distal end of the hair (1-3mm).…”

“…The yellow spots also occur in androgenetic alopecia (when hair follicle is empty at the xenogenous stage). 3,4,7 As the lesions progress to more chronic phases of AA the presence of these signs is no longer detected and mild follicular hyperkeratosis may occur, indicating a poor prognosis. 2.10 Finally, numerous telogen hairs can be observed in the trichogram 1,2,4-7 with bulbs or clubshaped tips either of similar size or with dystrophic tips (Figure 2).…”

“…1 In conclusion, we believe that a trichology examination assists the diagnosis and assessment of the progression of any capillary disorder. 3,7,8,10 In cases of suspected AA, a dermoscopy and trichogram enhances diagnostic confirmation while eliminating the need for invasive anatopathology evaluations etc. The trichological examination should therefore be incorporated into the diagnostic methods employed by the dermatologist given that it is a highly effective way of diagnosing AA.…”