Trichoscopy as an Essential Diagnostic Technique for Hair and Scalp Disorders in Skin of Color

Abstract

Background: Hair and scalp disorders cause significant morbidity, warranting an early diagnosis and treatment. Trichoscopy has shown great promise in the diagnosis and assessment of these disorders. Aims: The aim of this study was to determine the trichoscopic findings in cases of alopecia and scalp disorders and to determine their statistical significance. Materials and Methods: This was a case–control study in which trichoscopy using a hand-held dermoscope was done in 605 patients and 200 controls. Results: The trichoscopic findings that showed statistical significance in 405 alopecia cases when compared with controls were broken hair, exclamation hair, black dots, yellow dots, vellus hair and pigtail hair in alopecia areata, hair diameter variability, single hair predominance, brown and white peripilar sign in androgenetic alopecia, corkscrew hair, comma hair, morse-code hair and interfollicular scale in tinea capitis, and white dots and peripilar erythema in primary cicatricial alopecia. The findings which had a statistical relevance among scalp disorders included light red background, dots and globules and dermoscopic Auspitz’s sign for psoriasis, dark red background and arborizing vessels for eczemas and yellowish background for verrucae, comedo-like openings, milia-like cysts and moth-eaten borders for seborrheic keratosis, and viable nits for pediculosis capitis. Conclusion: Our study documented many trichoscopic features which were statistically significant among cases of alopecia and scalp disorders when compared with controls. Limitations: Histopathological confirmation of diagnosis was not done in most of the cases. The patients were not subjected to follow-up trichoscopy after treatment.