Validity of trichoscopy in the diagnosis of primary cicatricial alopecias

• Published in: International journal of dermatology 2016-10, Vol.55 (10), p.1106-1114
• Main Authors: Abedini, Robabeh, Kamyab Hesari, Kambiz, Daneshpazhooh, Maryam, Ansari, Mahshid Sadat, Tohidinik, Hamid Reza, Ansari, Mahsa
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alopecia - diagnostic imaging; Alopecia - etiology; Alopecia - pathology; Biopsy; Case-Control Studies; Cicatrix - etiology; Dermoscopy; Female; Folliculitis - complications; Folliculitis - diagnostic imaging; Folliculitis - pathology; Humans; Lichen Planus - complications; Lichen Planus - diagnostic imaging; Lichen Planus - pathology; Lupus Erythematosus, Discoid - complications; Lupus Erythematosus, Discoid - diagnostic imaging; Lupus Erythematosus, Discoid - pathology; Male; Middle Aged; Scalp Dermatoses - complications; Scalp Dermatoses - diagnostic imaging; Scalp Dermatoses - pathology; Sensitivity and Specificity; Skin - pathology; Young Adult
• ISSN: 0011-9059; 1365-4632
• DOI: 10.1111/ijd.13304

Background There are limited data on the validity of dermatoscopy in primary cicatricial alopecias (PCAs) and its subtypes, including lichen planopilaris and discoid lupus erythematosus. Trichoscopic features of PCAs, their prevalence, and validity were evaluated in this study. Methods One hundred patients with PCA underwent dermatoscopy. Biopsy specimens were obtained after the site was marked with a dermatoscope. The control group comprised 100 patients with non‐cicatricial alopecia and 100 normal individuals. Finally, the prevalence, sensitivity, and specificity of trichoscopic features were evaluated using SPSS and Stata software. Results The absence of follicular opening, perifollicular scale, and presence of one scarring pattern or white patch were sensitive and specific patterns in the trichoscopy of PCAs. The presence of tortuous branching vessels and follicular keratotic plugging was 100% specific for a diagnosis of discoid lupus erythematosus. Conclusions Some trichoscopic features can help a dermatologist to differentiate between non‐cicatricial alopecia and PCA. Moreover, a group of dermatoscopic features can be helpful in the diagnosis of PCA subtypes.