Dermoscopic Approach to a Small Round to Oval Hairless Patch on the Scalp

January 2014 in “ Annals of Dermatology ”

Woo-Haing Shim, Seung Wook Jwa, M Song, Hoon Soo Kim, Hyun Chang Ko, Byung Soo Kim, Moon Bum Kim

TLDR Dermoscopic examination helps diagnose different types of hair loss conditions by showing specific patterns.

The study, conducted from January 2008 to December 2011, involved 148 patients with small round or oval hairless patches on the scalp, diagnosed with various types of alopecia. Dermoscopic examination revealed specific findings for each condition: alopecia areata (AA) in 81 patients showed tapering hairs and yellow dots; trichotillomania (TM) in 24 patients and traction alopecia (TA) in 12 patients both showed broken hairs; tinea capitis (TC) in 13 patients had bent hairs, perifollicular white macules, and greasy scales; lichen planopilaris (LPP) in 8 patients and discoid lupus erythematosus (DLE) in 7 patients both showed a lack of follicular ostia, with DLE also having keratin plugs and LPP showing perifollicular hyperkeratosis and erythema. The study concluded that dermoscopic examination is useful for diagnosing these conditions and proposed a diagnostic algorithm, despite limitations such as the focus on common diseases and the patient population being exclusively Asian with black hair, which may limit the generalizability of the findings.

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