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

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