ReportThe role of scalp dermoscopy in the diagnosis of alopecia areata incognita
Section snippets
Case reports
All patients, 58 female and 12 male (mean age 33.37 years), presented with severe and diffuse hair loss, lasting from 2 weeks to 2 months before our examination. The patients were seen at the Department of Dermatology of the Universities of Bologna (50 patients) and Catania (20 patients), Italy, during the period of 2002 to 2006. All patients had severe hair thinning, often with a sudden loss of more than 60% of their scalp hairs. Clinical examination revealed diffuse hair thinning in all cases
Results
The dermoscopic features of the scalp were similar in all patients. Using the epiluminescent mode of operation, the scalp showed many diffuse, round or polycyclic yellow dots, which varied in size and were uniform in color and distribution. The yellow dots were evident within the follicular ostium of both empty and hair-bearing follicles and affected about 70% of the follicles. A large number of regrowing, tapered, terminal hairs (2-4 mm long) was also evident in the entire scalp (Fig 3).
Discussion
AAI is a variety of alopecia areata that mimics telogen effluvium. AAI has an acute onset and produces diffuse and severe hair thinning in a few months. Women are most commonly affected. Clinical history is negative for events known as possible causes of telogen effluvium.
From a pathological point of view, AAI should be suspected when high percentages of telogen hairs and/or miniaturized hairs are present even in the absence of a peribulbar lymphocytic infiltrate. The presence of a subtle
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Funding sources: None.
Conflicts of interest: None declared.
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