Bad Hair Days: A Clinical and Trichoscopic Evaluation of Scalp Lesions

June 2025 in “ Cureus ”

Abinayaa Rajkumar, Krishnakanth Muralidhar, Sai Preethi P, Adikrishnan Swaminathan, Murugan Sundaram, Sudha Rangarajan

trichoscopy alopecia scarring alopecia non-scarring alopecia psoriasis seborrheic dermatitis papulosquamous disorders

Studysummary In this study, trichoscopy was found to be a valuable non-invasive tool for diagnosing scalp lesions, enhancing diagnostic accuracy and reducing the need for scalp biopsies by identifying specific trichoscopic features associated with conditions like psoriasis, seborrheic dermatitis, and alopecia areata.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The study evaluated 200 patients with scalp lesions using trichoscopy, a non-invasive diagnostic tool, over 20 months. It found that trichoscopy significantly improved diagnostic accuracy for various scalp disorders, including papulosquamous disorders (39%), alopecia (31.5%), and infections (16%). Psoriasis and seborrheic dermatitis were the most common diagnoses, with distinct trichoscopic features aiding in differentiation. Trichoscopy effectively distinguished between scarring and non-scarring alopecia, reducing the need for invasive procedures like biopsies. The study concludes that trichoscopy should be an essential part of dermatological evaluations for scalp conditions due to its ease of use and diagnostic value.

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Research cited in this study

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research Identification of Trichoscopic Features of Allergic Scalp Contact Dermatitis: A Pilot Study of a Single Center

June 2023 in “Italian journal of dermatology and venereology”

In this retrospective study, researchers from the University of Bologna observed that trichoscopy can aid in diagnosing allergic scalp contact dermatitis, with key findings including common trichoscopic patterns of erythema, white scales, arborizing vessels, and simple red loops in 12 patients diagnosed with the condition.

research Trichoscopic Patterns of Scalp Dermatoses: An Observational Cross-Sectional Study

January 2023 in “Journal of Clinical and Diagnostic Research”

This study in Chennai, India, found that while some trichoscopic patterns are specific, many overlap across different scalp dermatoses, highlighting the importance of dermatologists staying informed about the latest findings.

research Comparison of Dermoscopic Findings in Female Androgenetic Alopecia and Telogen Effluvium and Female Controls in a Tertiary Care Center

May 2022 in “PubMed”

This study found that dermoscopic examination can significantly distinguish between female androgenetic alopecia and telogen effluvium based on hair diameter diversity and the presence of thin and vellus hairs.

research Trichoscopic Signs in Dermatomyositis, Systemic Lupus Erythematosus, and Systemic Sclerosis: A Comparative Study of 150 Patients

12 citations , December 2021 in “Dermatology”

This study found that trichoscopy can differentiate between dermatomyositis, systemic lupus erythematosus, and systemic sclerosis by identifying distinctive features and may help assess disease activity.

research Trichoscopy as an Essential Diagnostic Technique for Hair and Scalp Disorders in Skin of Color: A Case-Control Study

July 2021 in “Indian journal of dermatopathology and diagnostic dermatology”

In this study, researchers documented several trichoscopic features that were statistically significant indicators of alopecia and scalp disorders compared to healthy controls.

research An Overview of Scalp Dermatoses in a Tertiary Care Institute

April 2020 in “International Journal of Research in Dermatology”

This study observed that psoriasis and alopecia areata were the most common scalp dermatoses in an Indian population, primarily affecting adolescents and young adults with significant psychological impact.

research Trichoscopic Findings of Trichotillomania: New Observations

6 citations , January 2020 in “Postepy Dermatologii I Alergologii”

This study identified several specific trichoscopic features of trichotillomania, with trichoptilosis, V hair, and hair powder being the most frequent findings.

research The Role of the Microbiome in Scalp Hair Follicle Biology and Disease

73 citations , April 2019 in “Experimental Dermatology”

This review explores the hair follicle microbiome's interaction with the immune system, discussing its potential clinical implications for scalp health and disease but reports no new clinical results.

research Dermoscopic Findings in Scalp Psoriasis and Seborrheic Dermatitis: Two New Signs; Signet Ring Vessel and Hidden Hair

40 citations , December 2014 in “Indian Journal of Dermatology”

This study found that trichoscopy can effectively differentiate scalp psoriasis from seborrheic dermatitis by identifying specific trichoscopic patterns such as hidden hairs, signet ring vessels, and comma vessels.

research The Value of Trichoscopy in the Differential Diagnosis of Scalp Lesions in Pemphigus Vulgaris and Pemphigus Foliaceus

23 citations , November 2014 in “Anais Brasileiros de Dermatologia”

This study suggests that trichoscopy may assist in diagnosing pemphigus, particularly for scalp-specific lesions, by identifying certain characteristic features.

A Nonrandomized Study of Trichoscopy Patterns Using Nonpolarized (Contact) and Polarized (Noncontact) Dermatoscopy in Hair and Shaft Disorders

research A Nonrandomized Study of Trichoscopy Patterns Using Nonpolarized (Contact) and Polarized (Noncontact) Dermatoscopy in Hair and Shaft Disorders

34 citations , January 2014 in “International Journal of Trichology”

This study reported that polarized dermoscopy was better for visualizing vascular patterns, scaling, and reticular pigmentation, while nonpolarized mode better documented features like black dots and tapered hair in various hair and scalp conditions.

research Dermoscopy in Hair Disorders

12 citations , January 2014 in “Menoufia Medical Journal”

This review discusses the role of dermoscopy in diagnosing hair and scalp disorders, noting its ability to aid in differential diagnosis without the need for biopsies; it reports no new clinical results.

research A Practical Guide to Scalp Disorders

43 citations , November 2007 in “Journal of Investigative Dermatology Symposium Proceedings”

This paper reviews symptoms, causes, and treatment strategies for common scalp conditions such as dandruff and psoriasis, but does not present new clinical findings.