Trichoscopic evaluation of alopecia areata of the scalp and clinical correlation of these findings with disease activity and severity

Abstract

Background: Alopecia areata (AA) is a common, chronic inflammatory disease characterized by nonscarring hair loss on the scalp or any hair-bearing area of the body. Recently, trichoscopy has emerged as a noninvasive method for the evaluation of AA. Aim: Evaluating trichoscopic patterns in AA and correlating these with the disease activity and severity. Materials and Methods: Noncontact trichoscopy was performed on AA patients using polarized mode of DermLite dermatoscope. The trichoscopic patterns were recorded and analyzed to cognize their correlation with the disease activity and severity. Results: In our study, we observed 10 distinct types of hair under dermascope in 260 cases of AA. The most common type of AA was localized patch type. On trichoscopy, the most common finding was yellow dots (YDs) in 189 (72.71%) cases and other findings were short vellus hair (SVH), broken hair (BH), tapering hair (TH), black dot (BD), and trichoptilosis. Statistically significant positive correlation was observed between YDs, BD, BHs, TH, CD, and T and disease activity (r = 0.204, 0.389, 0.568, 0.683, 0.504, and 0.347 and P = 0.001, 0.000, 0.000, 0.000, 0.000, and 0.000, respectively). Statistically significant positive correlation was observed between TH, BH, and T and disease severity (r = 0.276, 0.250, and 0.146 and P = 0.000, 0.000, and 0.019, respectively). SVHs were correlated negatively with the disease activity and severity (r = −0.111, P = 0.075 and r = −0.141, P = 0.075, respectively). Conclusion: Our study has proved the utility of trichoscopy in evaluating AA. It has emerged as a useful noninvasive tool for evaluating classical and novel patterns and their correlation with the different determinants of the disease and assessing disease severity.