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.

View this study on onlinelibrary.wiley.com →

Discuss this study in the Community →

Research cited in this study

17 / 17 results

research Trichoscopy

42 citations, October 2012 in “Dermatologic Clinics”

Trichoscopy is a useful tool for diagnosing different hair and scalp diseases without surgery.

research Black Dots Seen Under Trichoscopy Are Not Specific for Alopecia Areata

42 citations, June 2012 in “Clinical and Experimental Dermatology”

Black dots under trichoscopy can appear in different hair and scalp conditions, not just in alopecia areata.

research Hair and Scalp Dermatoscopy

245 citations, March 2012 in “Journal of The American Academy of Dermatology”

Dermatoscopy is useful for identifying different hair and scalp conditions and can reduce the need for biopsies.

research Advances in the Management of Alopecia Areata

51 citations, December 2011 in “The Journal of Dermatology”

New treatments for severe hair loss often fail, but some patients see hair regrowth with specific therapies, and treatment should be tailored to the individual's situation.

research The Coudability Sign of Alopecia Areata: The Real Story

9 citations, March 2011 in “Clinical and experimental dermatology”

The document concludes that anticonvulsants like phenytoin may cause skin reactions by affecting tryptophan metabolism and suggests researching vitamin levels in patients with drug reactions.

research Reflectance Confocal Microscopy of the Yellow Dot Pattern in Alopecia Areata

39 citations, January 2011 in “Archives of Dermatology”

Reflectance confocal microscopy confirms that yellow dots are signs of damaged hair follicles in alopecia areata.

research Utility of Dermoscopy in Alopecia Areata

76 citations, January 2011 in “Indian Journal of Dermatology/Indian journal of dermatology”

Dermoscopy is a useful tool for diagnosing and managing alopecia areata.

research Trichoscopy for Common Hair Loss Diseases: Algorithmic Method for Diagnosis

89 citations, December 2010 in “The Journal of Dermatology”

The conclusion is that an algorithm using trichoscopy helps diagnose different types of hair loss but may need updates and a biopsy if results are unclear.

research Pinpoint White Dots in the Scalp: Dermoscopic and Histopathologic Correlation

60 citations, October 2010 in “Journal of the American Academy of Dermatology”

Small white dots on the scalp seen with a dermoscope correspond to sweat ducts and vary with different hair disorders.

research Coudability Hairs: A Revisited Sign of Alopecia Areata Assessed by Trichoscopy

56 citations, June 2010 in “Clinical and experimental dermatology”

Coudability hairs are useful markers for alopecia areata activity.

research Alopecia Areata Update

391 citations, January 2010 in “Journal of The American Academy of Dermatology”

Half of people with Alopecia Areata may see hair regrowth within a year without treatment, but recovery is unpredictable.

research Dermoscopy in Female Androgenic Alopecia: Method Standardization and Diagnostic Criteria

129 citations, January 2009 in “International Journal of Trichology”

Trichoscopy can diagnose female hair loss with high accuracy by looking for specific patterns in hair and scalp appearance.

research Dermoscopy Findings of Alopecia Areata in an African-American Patient

25 citations, December 2008 in “Journal of Dermatological Case Reports”

Skin color may change how alopecia areata looks under a dermoscope.

research Clinical Significance of Dermoscopy in Alopecia Areata: Analysis of 300 Cases

196 citations, June 2008 in “International Journal of Dermatology”

Dermoscopy helps diagnose and manage alopecia areata by showing specific hair changes.

research Videodermoscopy in the Evaluation of Hair and Scalp Disorders

304 citations, July 2006 in “Journal of The American Academy of Dermatology”

Videodermoscopy improves diagnosis of hair and scalp disorders and may reduce scalp biopsies.

research Alopecia Areata in C3H/HeJ Mice Involves Leukocyte-Mediated Root Sheath Disruption in Advance of Overt Hair Loss

37 citations, November 2003 in “Veterinary pathology”

Hair loss in mice starts with immune cells damaging hair roots before it becomes visible.

research Diagnostic Value of Exclamation Mark Hairs

26 citations, January 1993 in “Dermatology”

Exclamation mark hairs are not exclusive to alopecia areata.

Related Community Posts Join

6 / 1000+ results

community Diffuse hair loss and scalp biopsies

in Research 692 upvotes 4 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

community My experience and a discourse on “DUPA”

in Chat 46 upvotes 2 years ago

How diffuse unpatterned alopecia (DUPA) is not an invitation to self-diagnose oneself with aggressive AGA and that seeking a specialized dermatologist may help people experiencing hair loss. Treatment options discussed include topical clobetasol propionate, oral minoxidil, and discontinuing finasteride.

community Seeking Advice: Unusual Hair Loss at 31 Years Old - Any Insights? (M)

in Chat 15 upvotes 8 months ago

A 31-year-old man who previously had good results with minoxidil, finasteride, and nizoral for hair loss is now experiencing unusual hair loss and side effects from finasteride. Respondents suggest it might be severe retrograde alopecia and recommend exploring other treatment options due to his inability to tolerate finasteride.

community DUPA VS. FAPD, which is more treatable? Which is worse?

in Research/Science 8 upvotes 2 weeks ago

DUPA is considered more treatable than FAPD, as FAPD involves scarring that prevents hair regrowth. The user has started treatment with oral dutasteride and minoxidil, hoping for better results than previous treatments.

community How essential is scalp biopsy when dealing with hair loss?

in Treatment 6 upvotes 1 month ago

The user experienced hair loss despite using Fin and Min for 12 years and switched to Dutasteride, RU58841, and Keto scalp serum, but shedding and itch persist. They are considering increasing Dutasteride to 2.5mg and questioning the necessity of a scalp biopsy, with mixed opinions on its usefulness.

community I bought a microscope, how does my scalp/hairs look? I've been suffering diffuse thinning and hair loss after covid and never recovered (2 yrs ago) I eat healthy, in shape and workout.

in Progress Pictures 86 upvotes 9 months ago

A person with hair loss since COVID-19 is considering treatments like finasteride and minoxidil but is hesitant due to potential side effects. Suggestions include visiting a dermatologist, using a ketoconazole shampoo, and considering that post-COVID hair loss might be an autoimmune response.

Related Research

8 / 8 results

research Androgenetic Alopecia

January 2023 in “Springer eBooks”

Most older adults experience pattern hair loss due to shrinking hair follicles, with men and women showing different balding patterns.

research Alopecia Areata and Homeopathy

January 2023 in “International journal of homoeopathic sciences”

The document says homoeopathic treatments are good for hair regrowth in alopecia areata but doesn't give proof.

research Androgenetic Alopecia Pattern Hair Regrowth in Patients with Alopecia Areata Treated with Oral JAK Inhibitors

November 2020 in “Journal of The American Academy of Dermatology”

Oral JAK inhibitors help regrow hair in alopecia patients.

research Hair Loss (Alopecia or Baldness)

June 2018

Baldness is often hereditary and linked to male hormones, becoming noticeable when half the hair is lost.

research A Bald Statement: Current Approaches to Manipulate Miniaturization Focus Only on Promoting Hair Growth

30 citations, May 2018 in “Experimental Dermatology”

The conclusion is that future hair loss treatments should target the root causes of hair thinning, not just promote hair growth.

research Hair Restoration Surgery: Follicular Unit Grafting

December 2016

Follicular unit grafting is a procedure used to treat hair loss, where small hair grafts are placed into the scalp, with future treatments likely to involve smaller incisions and cell-based therapies.

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

26 citations, August 2013 in “Australasian Journal of Dermatology”

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

research An Overview of Female Pattern Hair Loss

2 citations, June 2011 in “Expert Review of Dermatology”

Female pattern hair loss involves thinning hair on crown and frontal scalp, diagnosed by hair ratio, and treated with minoxidil, antiandrogens, or hair transplantation.