Reflectance Confocal Microscopy for Scarring and Non-Scarring Alopecia Real-Time Assessment

May 2016 in “ Archives of Dermatological Research ”

Marco Ardigò, Marina Agozzino, Chiara Franceschini, Carlo Donadio, Leonardo Spagnol Abraham, Luca Barbieri, Isabella Sperduti, Enzo Berardesca, Salvador González

reflectance confocal microscopy scarring alopecia non-scarring alopecia intra-epidermal inflammation peri-adnexal infiltration dermal infiltration inflammatory cells melanophages androgenic alopecia alopecia areata dermoscopy RCM SA NSA inflammation AGA AA

TLDR Reflectance confocal microscopy can help tell apart scarring from non-scarring hair loss.

The study investigated the use of reflectance confocal microscopy (RCM) to distinguish between scarring alopecia (SA) and non-scarring alopecia (NSA) in 86 patients. It found specific RCM features that could predict SA, such as intra-epidermal inflammation and peri-adnexal and dermal infiltration of inflammatory cells, with melanophages being more frequently detected in SA. While RCM could differentiate between SA and NSA, no significant differences were found between androgenic alopecia and alopecia areata. The study suggests RCM could enhance non-invasive alopecia assessment in combination with dermoscopy, despite limitations like cost and the need for specialized training. Further research is needed to validate RCM's use in treatment monitoring and distinguishing between different alopecia subtypes.

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