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- Presentation
Diagnosis of Non-Scarring Hair Loss by Trichoscopy
Description
The lecture discusses the diagnosis of non-scarring hair loss using trichoscopy, emphasizing the importance of understanding hair follicle pathogenesis to interpret visible features effectively. Key conditions such as androgenetic alopecia (AGA), acute telogen effluvium, alopecia areata, trichotillomania, and tinea capitis are explored. For AGA, trichoscopy reveals hair shaft diameter diversity and miniaturization, with a threshold of over 20% thin hairs indicating disease severity. Acute telogen effluvium is recognized through regrowing short hairs and clinical history. Alopecia areata is characterized by features like broken hairs and pseudo-monilethrix. For trichotillomania, the presence of broken hairs of varying lengths is noted. Tinea capitis involves fungal invasion resulting in corkscrew hairs and morse code hairs. The use of trichoscopy allows for prompt diagnosis and treatment, even before fungal cultures provide results. Clinical case examples demonstrate how trichoscopic findings guide diagnosis and clinical decisions, highlighting the effectiveness of this technique in dermatological practice.
View moreConclusions
- Trichoscopy provides valuable insights into the diagnosis and progression of non-scarring hair loss conditions.
- Androgenetic alopecia is characterized by hair shaft diameter diversity and miniaturization, with a significant proportion of thin hairs indicating disease severity.
- In acute telogen effluvium, the presence of short regrowing hairs can serve as a reassuring sign of hair recovery.
- Alopecia areata involves an inflammatory attack on hair follicles, leading to features like broken hairs and exclamation marks, indicative of disease activity.
- Trichotillomania is identified by broken hairs of varying lengths and a negative pull test, distinguishing it from alopecia areata.
- Tinea capitis diagnosis can be established through characteristic trichoscopic features, allowing for immediate treatment prior to culture results.
- Trichoscopic patterns in tinea capitis can suggest the causative fungal agent, aiding targeted treatment.
- Int J Trichotogy. 2013 Jul;5(3):118-20.
- Waśkiel-Burnat A, Rakowska A, Sikora M, Ciechanowicz P, Olszewska M, Rudnicka L. Trichoscopy of Tinea Capitis: A Systematic Review. Dermatol Ther (Heidelb). 2020 Feb;10(1):43-52.
- Waśkiel-Burnat A, Rakowska A, Sikora M, Ciechanowicz P, Olszewska M, Rudnicka L. Trichoscopy of Tinea Capitis: A Systematic Review. Dermatol Ther (Heidelb). 2020 Feb;10(1):43-52. doi: 10.1007/s13555-019-00350-1. Epub 2020 Jan
- Meneses O, Donati A, Silva FO, Mimiça MJ, Machado CJ, Veasey JV. Trichoscopy patterns of tinea capitis and their correlation with mycological culture results. J Am Acad Dermatol. 2021 Dec 11:S0190-9622(21)02967-4. doi: 10.1016/j.jaad.2021.12.010. Online ahead of print.