Unusual Dermoscopic Features in a Patient with Alopecia Areata
July 2019
in “
Indian dermatology online journal
”
alopecia areata alopecia totalis trichoscopic features black dots yellow dots cadaverized hairs short vellus hairs red-dotted vessels perifollicular lymphocytic infiltrates intralesional steroids topical corticosteroids dithranol dermoscopic patterns vascular patterns inflammation hair loss total hair loss hair examination features dead hairs fine hairs blood vessels immune cells steroid injections steroid creams anthralin skin examination patterns blood vessel patterns swelling
TLDR Alopecia areata can show unusual red-dotted vessels and dithranol treatment may mask typical patterns.
A 21-year-old female with extensive alopecia areata progressing to alopecia totalis exhibited typical trichoscopic features such as black dots, yellow dots, cadaverized hairs, and short vellus hairs, along with unusual red-dotted vessels in interfollicular areas. Histopathology revealed dense perifollicular lymphocytic infiltrates. Despite various treatments, including intralesional steroids and topical corticosteroids, the response was poor. Short contact dithranol caused irritation and black staining, which subsided after discontinuation. The case highlighted the potential for dithranol to mask typical dermoscopic patterns and the presence of atypical vascular patterns, which may be influenced by treatment-induced inflammation.
