Different trichoscopic features of tinea capitis and alopecia areata in pediatric patients.

Abd-Elaziz El-Taweel,Fatma El-Esawy,Osama Abdel-Salam

doi:10.1155/2014/848763

Abstract

Background. Diagnosis of patchy hair loss in pediatric patients is often a matter of considerable debate among dermatologists. Trichoscopy is a rapid and noninvasive tool to detect more details of patchy hair loss. Like clinical dermatology, trichoscopy works parallel to the skin surface and perpendicular to the histological plane; like the histopathology, it thus allows the viewing of structures not discovered by the naked eye. Objective. Aiming to compare the different trichoscopic features of tinea capitis and alopecia areata in pediatric patients. Patients and Methods. This study included 40 patients, 20 patients with tinea capitis and 20 patients with alopecia areata. They were exposed toclinical examination, laboratory investigations (10% KOH and fungal culture), and trichoscope examination. Results. Our obtained results reported that, in tinea capitis patients, comma shaped hairs, corkscrew hairs, and zigzag shaped hairs are the diagnostic trichoscopic features of tinea capitis. While in alopecia areata patients, the most trichoscopic specific features were yellow dots, exclamation mark, and short vellus hairs. Conclusion. Trichoscopy can be used as a noninvasive tool for rapid diagnosis of tinea capitis and alopecia areata in pediatric patients.

Highlights

Losing hair is not usually health threatening; it can scar a young child’s vulnerable self-esteem by causing immense psychological and emotional stress, to the patient, and to the concerned parents and siblings [1]; so the cause of hair loss should be diagnosed and treated early to overcome the resulting problems [2]
Direct microscopic examination of the collected specimens from the lesion(s) after being mounted by KOH 10% was done for all patients and revealed that 13 patients, 32.5%, of tinea capitis gave positive result, 7 patients, 17.5%, gave false negative results, and all cases of alopecia areata gave negative results
In patients with tinea capitis, the most common trichoscopic feature (Figure 1) was short broken hairs seen in 18 patients, 90.0%, followed by black dots in 13 patients, 65.0%, comma shaped hairs in 11 patients, 55.0%, or corkscrew hairs in 9 patients, 45.0%, and zigzag shaped hair in 5 patients, 25.0% (Table 1)

Summary

Introduction

Losing hair is not usually health threatening; it can scar a young child’s vulnerable self-esteem by causing immense psychological and emotional stress, to the patient, and to the concerned parents and siblings [1]; so the cause of hair loss should be diagnosed and treated early to overcome the resulting problems [2]. The most frequent causes of hair loss in pediatric patients include tinea capitis, alopecia areata, traction alopecia, and trichotillomania. Typical first symptoms of alopecia areata are small bald patches; the underlying skin looks superficially normal. These patches can take many shapes but are most usually round or oval [6]. Aiming to compare the different trichoscopic features of tinea capitis and alopecia areata in pediatric patients. This study included 40 patients, 20 patients with tinea capitis and 20 patients with alopecia areata They were exposed toclinical examination, laboratory investigations (10% KOH and fungal culture), and trichoscope examination. Trichoscopy can be used as a noninvasive tool for rapid diagnosis of tinea capitis and alopecia areata in pediatric patients

Objectives

Methods

Results

Conclusion