Clinical, trichoscopic, and histopathologic characteristics of patients with alopecia and hypothyroidism: An observational study

    Sergio Leal-Osuna, Diana Emma Becerril-Parra, Fátima Tinoco-Fragoso, Ana García-Gil, Marí­a Elisa Vega-Memije, Lorena Lammoglia-Ordiales
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    TLDR Hypothyroidism patients with hair loss typically have thinning hair, smaller hair follicles, and normal hair shedding.
    The observational study, conducted on 15 female patients with hypothyroidism, found that alopecia associated with the condition often presents with bi-parietal involvement (80%), extension to the vertex and superior occipital region (33.3%), and diffuse alopecia (20%). Trichoscopic examination revealed perifollicular scaling in 93.3% of patients, decreased hair shaft diameter in 86.6%, and single follicular units in 53.3%. Histologically, an average of 31 hairs were found per field, with a decreased terminal/vellus ratio in 86.6% of cases, indicating follicular miniaturization rather than histologic telogen effluvium. The study suggests that alopecia in hypothyroidism patients is characterized by diffuse thinning, miniaturization, and a normal telogen count, and should be considered in differential diagnosis for alopecia. The study's conclusions are limited by its small sample size and observational design.
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