Trichoscopic Findings in Alopecia Areata and Their Relation to Disease Activity, Severity, and Clinical Subtype in Turkish Patients

August 2013 in “ Australasian Journal of Dermatology ”

Melike Kibar, Şebnem Aktan, Banu Lebe, Muzaffer Bilgin

alopecia areata trichoscopic findings honeycomb hyperpigmentation cumulus-like clustered white dots white dots black dotted pigmentation exclamation mark hairs atypical red vessels multi-hair follicular units hidden hairs AA trichoscopy

TLDR Certain scalp patterns can indicate the severity and activity of hair loss in Turkish alopecia patients.

In the 2013 study involving 39 Turkish patients with alopecia areata (AA) and 309 with other types of alopecia, trichoscopic examinations revealed no significant relationship between AA subtype and trichoscopic findings. However, certain trichoscopic patterns were associated with AA severity and activity. Severe AA was linked to honeycomb hyperpigmentation, cumulus-like clustered white dots, white dots, and black dotted pigmentation, while mild AA was associated with exclamation mark hairs, which also indicated active disease. Atypical red vessels and white dots were negatively related to disease activity. The study introduced new trichoscopic signs for AA, including clustered white dots, multi-hair follicular units, hidden hairs, and black dotted pigmentation, which could help in diagnosing and predicting AA's course. The study's limitations were the small sample size and lack of histopathological confirmation for the new signs.

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