A Prospective Study of Dermoscopic and Ultrastructural Features of Vitiligo-Associated Leukotrichia

The study examined the dermoscopic and ultrastructural features of Vitiligo-Associated Leukotrichia (VAL) in 100 patients. The most common dermoscopic signs of VAL were perifollicular depigmentation, clustered leukotrichia, white area, and telangiectasia. Certain signs were more prevalent in different stages of the disease, with diameter diversity of leukotrichia, Pohl-Pinkus constrictions, and depigmented hair roots more common in the progressive stage, and clustered leukotrichia more common in the stable stage. The duration of leukotrichia was shorter in patients with Pohl-Pinkus constrictions, depigmented hair roots, and diameter diversity of leukotrichia, and longer in patients with clustered leukotrichia. Electron microscopy showed that white hair shafts were thinner than black ones and had lower electron reflectivity. The study also found similarities between VAL and alopecia areata (AA), suggesting potential shared pathways. The study had limitations including reliance on clinical diagnosis of VAL without histopathologic test confirmation, and insufficient sample size to analyze dermoscopic signs by disease types.