Reflectance Confocal Microscopy of the Yellow Dot Pattern in Alopecia Areata

In a study from 2011, researchers used reflectance confocal microscopy (RCM) to examine the yellow dot pattern in six patients with alopecia totalis, a form of alopecia areata. Dermoscopy showed yellow dots in all patients, and these dots sometimes had miniaturized or broken hair shafts. RCM revealed a decrease in follicular structures and empty lumina with highly refractile material, which matched the yellow dots seen in dermoscopy. Pathological analysis showed that these dots were dilated infundibula of vellus-like anagen and telogen follicles, which are common in chronic alopecia areata. The study's findings demonstrated that RCM could effectively correlate with dermoscopic and pathological features, confirming that the yellow dots are indeed indicative of compromised follicular structures with occasional hair remnants.