Black Dots Seen Under Trichoscopy Are Not Specific for Alopecia Areata

    June 2012 in “ Clinical and Experimental Dermatology ”
    Elżbieta Kowalska-Olędzka, Monika Słowińska, Adriana Rakowska, Joanna Czuwara, Justyna Sicińska, Małgorzata Olszewska, Lidia Rudnicka
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    TLDR Black dots under trichoscopy can appear in different hair and scalp conditions, not just in alopecia areata.
    The study, which included 107 patients with various forms of hair loss and 93 healthy controls, found that black dots seen under trichoscopy are not exclusive to alopecia areata (AA). These dots were observed in 53.3% of AA patients, but also in cases of severe chemotherapy-induced alopecia, dissecting cellulitis of the scalp, hypotrichosis simplex, and congenital aplasia cutis. No black dots were found in patients with androgenetic alopecia (AGA) or chronic telogen effluvium (TE). The presence of black dots was associated with the acute phase of hair loss and the intensity of inflammation. The study concluded that black dots can occur in various hair and scalp diseases, not just AA, and their significance in healthy controls is still unknown. However, the study had limitations, including a small number of patients with certain conditions and the inability to use advanced imaging techniques on all patients.
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