Trichoscopy-Assisted Hair Pull Test: A Helpful Adjunct to Trichoscopy for Diagnosing and Managing Alopecias

The document discusses the "trichoscopy-assisted hair pull test," a non-invasive diagnostic method proposed as an adjunct to trichoscopy for evaluating patients with hair loss. The method involves performing a hair pull test and then using dermoscopy to examine the proximal hair shafts and roots of the pulled hairs. Three case studies are presented to illustrate the diagnostic and therapeutic benefits of this method. In the first case, a 22-year-old female with rapid-onset hair shedding was initially suspected of having telogen effluvium (TE), but the trichoscopy-assisted hair pull test revealed features of alopecia areata (AA), leading to a correct diagnosis and effective treatment. The second case involved a 78-year-old female with methotrexate-induced acute TE superimposed on androgenetic alopecia (AGA), and the third case was a 65-year-old female diagnosed with lichen planopilaris (LPP) through the identification of anagen roots. The authors conclude that the trichoscopy-assisted hair pull test is a useful tool for diagnosing various types of hair loss, particularly when the classic hair pull test is positive.