Findings Of Alopecia Areata Research Articles

Trichoscopic findings in children and adults with alopecia areata: A comparative study.

Alopecia areata is a chronic and relapsing condition that affects individuals of all age groups. Dermoscopy is a popular and non-invasive method for diagnosing alopecia areata. This study aimed to analyze dermoscopic findings and their relationship with age, gender, appearance, and clinical signs in children and adults. This retrospective cross-sectional study was conducted on 124 children and adults diagnosed with alopecia areata who were referred to a Hospital in Iran between 2021 and 2022. After reaching the calculated sample size, trichoscopic findings were examined and the results were recorded. Data analysis was performed by a statistician and presented in relevant tables. The participants in the study comprised 53.2% female children, 46.8% male children, 27.42% adult males, and 72.58% adult females. The median age in the pediatric group was 10 years, while it was 27 years in the adult group. Yellow dots were significantly less observed in children than in adults (29% vs. 48.4%), while exclamation mark hairs were significantly more common in children than adults (38.7% vs. 21%). No significant differences were found in the frequency of other trichoscopic features between children and adults. Specifically, black dots, broken hairs, short vellus hairs, pigtail hairs, and empty follicular openings were observed in 38.7%, 40.3%, 32.3%, 11.3%, and 75.8% of children, respectively, and in 35.5%, 32.3%, 21%, 46.8%, and 12.9% of adults, respectively. The most common trichoscopic findings in alopecia areata in children are empty follicular openings and broken hairs, while exclamation mark hairs are more common in children than adults. In contrast, yellow dots are less frequently observed in children compared to adults. This distinct difference between children's and adults' dermoscopic findings highlights the critical need for age-specific considerations in AA evaluations.

Trichoscopy pattern in alopecia areata: A systematic review and meta-analysis.

The incidence of alopecia areata (AA) has increased over the last few decades. Trichoscopy is a noninvasive procedure performed in dermatology clinics and is a helpful tool in determining the correct diagnosis of hair loss presentations. Through mapping the researches that have been done to represent the spectrum of trichoscopic findings in AA and to identify the most characteristic patterns. Thirty-nine studies were eligible for the quantitative analysis. Meta-analysis and subgroup analysis were performed. Thirty-nine studies (29 cross-sectional, five retrospective, two descriptive, one case series, one observational, and one cohort) with a total of 3204 patients were included. About 66.7% of the studies were from Asia, 25.6% from Europe, and 7.7% from Africa. The most characteristic trichoscopic findings of AA were as follows; yellow dots, black dots, broken hairs, short vellus hairs, and tapering hairs. There is no single pathognomonic diagnostic trichoscopic finding in AA rather than a constellation of characteristic findings. The five most characteristic trichoscopic findings in AA are: yellow dots, black dots, broken hairs, short vellus hairs, and tapering hairs. Yellow dots and short vellus hairs considered the most sensitive clues for AA, while black dots and tapering hairs are the most specific ones. Furthermore, trichoscopy is a useful tool that allows monitoring of response during the treatment of AA. Treatment responded cases will show an increase in short vellus hairs, but loss of tapering hairs, broken hairs, and black dots, while yellow dots are the least responsive to the treatment.

Clinical profile and dermoscopic findings in alopecia areata

Background: Alopecia areata (AA) is a common, chronic, and inflammatory disease that causes non-scarring hair loss. Dermoscopy can be used not only to diagnose AA and differentiate other causes of patchy alopecia but can also be a useful tool in assessing the severity of the disease. Aim and Objectives: The aim of the study was to study the clinical profile, various dermoscopic findings, and correlation between different dermoscopic findings and disease severity of AA. Materials and Methods: It was a cross-sectional descriptive study including clinically diagnosed cases of AA attending the outpatient department of dermatology. A detailed history and clinical examination was done along with dermoscopy of lesion and the patterns were noted. Results: A total of 117 patients were included in study. About 44% patients had mild AA, 48% had moderate, and 8% had severe alopecia. Patients with atopy and family history had an early onset of disease. Family history, presence of diabetic mellitus, and nail changes were associated with severe disease. The most common dermoscopic finding noted in our study was black dots followed by short vellus hairs, broken hairs, yellow dots, and tapering hairs. Yellow dots correlated positively with severity of AA while black dots, broken hairs, and short vellus hairs correlated negatively with the severity of AA. There was no relation between tapering hairs and severity of AA. Conclusion: AA is a disease of younger age. Black dots are the most common dermoscopic findings and along with this other patterns can be useful in diagnosis and assessment of severity of disease.

Role of Trichoscopy in Evaluation of Alopecia Areata: A Study in a Tertiary Care Referral Centre in the Eastern India.

Background:Alopecia areata is an autoimmune disorder affecting the hair-bearing sites of the body. Trichoscopy has recently been practiced in the diagnosis of alopecia areata.Aim:To elicit trichoscopy patterns in alopecia areata and to find out any correlation of trichoscopic findings with disease severity.Methods:Trichoscopy was done on clinically diagnosed cases of alopecia areata and on age and sex-matched controls without hair disorders by using a DL1 dermoscope (magnification: ×10). Observed dermoscopic findings were analyzed to find the correlation with disease severity.Results:In total, 87 cases and 60 controls were included in the study with the mean age for cases being 25.47 ± 14.07 years. There was male predominance of cases (51; 58.62%). Alopecia in multiple patches was the most common type (42; 48.27%), and scalp was the most common site of involvement (79; 90.8%). Yellow dots (YD), black dots (BD), broken hairs (BH), circle hair (CH), and tapering hairs (TH) or exclamation hair (EH) were found to be statistically significant findings in alopecia areata as compared to controls. Circle hair was significantly associated with total severity of alopecia areata (P = 0.041). Yellow dots had a positive correlation with the number of episodes of alopecia areata (Spearman's rho = 0.273, P = 0.0106) and mean severity of alopecia tool (SALT) score (P = 0.0130). No significant association was noted between trichoscopic findings and disease activity, family history, disease associations, or nail involvement.Conclusion:A constellation of trichoscopic findings helps in establishing the diagnosis of alopecia areata obviating the need for biopsy.

Lesson to Learn From Cellular infiltrate in Scalp Biopsy of Alopecia Areata.

Alopecia areata (AA) is a common cause of hair loss. It is mediated by T lymphocytes. Scalp biopsy findings in AA differ according to the disease phase and activity. To study the cellular infiltrate in the transverse section of scalp biopsy of AA at different disease stages and in relation to disease activity. The study was performed on 40 subjects with AA. A 4-mm punch biopsy was obtained from an AA scalp lesion. Biopsies were sectioned horizontally; 2 anatomical levels were studied (mid dermal and deep dermal levels). Ninety-five percent of AA showed noncicatrical alopecia. A significant relation was found between the course of AA and the terminal:vellus ratio. Peribulbar lymphocytic infiltration was seen in 70% of cases. Mast cells were observed in 87.5% of cases, including fibrous tract and around the arrector pili muscles. Eosinophils were detected in the scalp biopsy of 22.5% of cases. Course and activity of AA were significantly related to the peribulbar lymphocytic cell infiltration but not to mast cells and eosinophils. Although a peribulbar lymphocytic infiltrate is the classical finding of AA, it is absent in the chronic phase. Mast cells are commonly found in the scalp biopsy of AA and could explain the potential therapeutic effect of antihistamines.

To Study Dermoscopic Findings in Alopecia Areata

Introduction: Alopecia areata is a common chronic autoimmune inflammatory disease that involves hair follicles, characterized by hair loss on the scalp and/or body without scarring. Clinically, the disease presents as smooth, patchy hair loss with various patterns - diffuse or reticulate alopecia, ophiasis, ophiasis inversus, alopecia totalis (loss of hair all the scalp), or alopecia universalis (loss of hair all over the body). Clinical diagnosis of AA is made based on typical pattern of hair loss and the presence of characteristic exclamation mark hair in microscopy. Invasive (punch biopsy) techniques are often required in some cases where the clinical diagnosis is not straight forward Biopsy shows peribulbar lymphocytic infiltrates in a “swarm of bee pattern” which is characteristic of the acute stage of the disease.
 Dermoscopy is an imaging instrument that immensely magnifies surface features of skin lesions. It works on the principle of illumination and transillumination of skin with different light sources and studying it with a high magnification lens. Dry dermoscopy was done with heine delta 20 dermoscope which was followed by wet dermoscopy. Liquid paraffin was used as the immersion media. It is a noninvasive, repeatable, recordable bedside investigation.
 Objective: To study dermoscopic findings in alopecia areata.
 Materials and Methods: Study Design: Cross sectional study; Study Area: Skin Outpatient Department, Sree Balaji Medical College and Hospital; Study Population: All patients with hair loss, attending skin OPD, who are clinically diagnosed as Alopecia Areata; Study Method: Observational study; Sample Size: 30.
 Results: Clinically, the disease presents as smooth, patchy hair loss with various patterns. Dermoscopy is useful for diagnosis of AA clinically by the presence of cadaverized hairs (black dots), circle hair, coudablity hair, exclamation mark hairs (tapering hairs), broken hairs, yellow dots and clustered short vellus hairs in the hair loss areas. The results wear tabulated.

ALOPECIAAREATAAND TRICHOSCOPY: AN OBSERVATIONAL STUDY

Background: Alopecia areata (AA) is a common type of non-scarring alopecia. Genetic predisposition, autoimmunity, and environmental factors play a major role in the etiopathogenesis of AA. Trichoscopy is a simple and a non invasive technique used to detect various types of scalp and hair disorders. It is a simple bed side test which avoids unnecessary biopsies, besides diagnosing the condition it also helps in determining the treatment response. Aim and Objectives: To determine the various trichoscopic findings in alopecia areata. Materials and Methods: 50 patients with clinically diagnosed alopecia areata were enrolled for the present study. Trichoscopy was done using a digital microscope system in both non polarized and polarized modes after obtaining written informed consent. Result: Most common trichoscopic finding was yellow dots seen in 86% followed by short vellus hairs seen in 76%, broken hair in 60% and black dots in 44% patients respectively.

Trichoscopic findings in alopecia areata- a cross sectional study

Alopecia areata remains one of the common cases presenting in clinical practice. Considering the anxious state of patients it becomes very important to correctly diagnose the cause and type of alopecia followed by the appropriate treatment. Trichoscopy is a novel, sensitive, non invasive modality which provides rapid detection of alopecia areata with advanced diagnostic accuracy, predicts the cause of disease and decreases unnecessary biopsies. To determine the Trichoscopic findings in alopecia areata in adult population. 122 patients with clinically diagnosed alopecia areata were enrolled. After taking proper history and consent trichoscopy was done using a Dinolite digital microscope system in both non polarized and polarized modes and their photographs were taken. 122 patients with alopecia areata were enrolled. Yellow dots were the most common trichoscopic findings observed in 108 (88.5%) patients followed by short vellus hair 66 (54.1%), short regrowing hair 58 (47.5%), exclamation mark hair 56 (45.9%), black dots 44 (36.1%) and broken hair 34 (27.9%).

To Study Dermoscopic Findings in Alopecia Areata

To Study Dermoscopic Findings in Alopecia Areata

Trichoscopy of alopecia areata: An update.

The diagnosis of alopecia areata is usually based on clinical manifestations. However, there are several hair and scalp disorders that share similar clinical features with alopecia areata, such as tinea capitis, trichotillomania or traction alopecia. Trichoscopy as a fast, non-invasive and easy-to-perform technique may help to identify subtle details and establish the correct diagnosis. The aim of this review is to present the spectrum of trichoscopic findings in alopecia areata. A systematic review of the published work was performed by searching the PubMed, Scopus and EBSCO databases, complemented by a thorough hand search of reference lists. Of 427 articles retrieved, 30 studies were eligible for quantitative analysis. The reported features of alopecia areata were: yellow dots (6-100% patients), short vellus hairs (34-100%), black dots (0-84%), broken hairs (0-71%) and exclamation mark hairs (12-71%). Tapered hairs (5-81%) were reported in few studies, but a relatively high frequency of this finding in alopecia areata may indicate their important role in the differential diagnosis of hair loss. Rarely reported features, which include upright regrowing hairs (11-96%), pigtail (circle) hairs (4-61%) and Pohl-Pinkus constrictions (2-10%), may also be helpful in the diagnosis of alopecia areata. There is no pathognomonic trichoscopic marker for alopecia areata and the most common trichoscopic features are not the most specific. Therefore, the diagnosis should be based on the coexistence of several trichoscopic findings, not on the presence of a single feature.

Ocular findings in alopecia areata.

Alopecia areata is a T cell mediated disease with which many disorders may be associated. There are few studies reporting ocular findings in alopecia areata. The aim of the study is to assess tear function and ocular surface pathologies in alopecia areata. Thirty-two patients with alopecia areata and 20 age- and sex-matched healthy controls were enrolled in the study. Ocular surface disease index questionnaire, Schirmer, tear break-up time, and corneal staining stage tests were done. The data was analyzed using SPSS 10.0 software. One-way variance analysis and Chi-square tests were used as tests of significance. The patient group had significantly higher ocular surface disease index questionnaire and corneal staining stage test scores and lower tear break-up time test scores compared with the control group (P < 0.05). Dry eye disease (DED) was diagnosed in 27 (84%) of 32 alopecia areata patients and in only 3 (15%) of 20 controls, and there was a significant difference between the groups (P < 0.01). T cell mediated autoimmunity has a prominent role in the etiopathogenesis of alopecia areata and dry eye disease. We think that inflammatory mechanisms causing alopecia areata may trigger dry eye disease or vice versa. All patients with AA should be referred to an ophthalmologist for the evaluation of DED and other possible eye pathologies.

Dermoscopic findings of alopecia areata in dark skinned individuals: an analysis of 116 cases.

Background:Several dermoscopic findings in alopecia areata (AA) are characteristic and aid in the diagnosis of this disease. Studies evaluating the clinical significance of these findings in AA in dark-skinned individuals are sparse. There is no literature of correlation of dermoscopic findings to severity of disease.Aims:The aim was to determine the dermoscopic findings of AA in dark skinned individuals and to assess whether certain dermoscopic findings correlate with disease activity and severity.Materials and Methods:Totally 116 patients with AA were included in the study. After a thorough clinical history and examination to note type, severity and activity of the disease, dermoscopy was performed using a Heine Delta 20 dermoscope (Heine optotechnik,Herrsching, Germany) and the results were noted in a proforma. Statistical analysis was performed using SPSS13 software using appropriate statistical tools.Results:Dermoscopic findings were nearly similar to that described in western literature. Yellow dots (YDs) were found to be highly sensitive for diagnosis, increased frequency being seen in Indian prepubertal patients when compared with western literature. YDs/field of vision (FOV) were found more frequently in severe types of AA. There was no correlation of dermoscopic findings to severity of disease.Conclusion:Dermoscopic features are similar to that described in the literature. However, YDs are seen in higher frequency. YDs/FOV could serve as dermoscopic criteria to grade severity of AA.

Trichoscopic findings in alopecia areata and their relation to disease activity, severity and clinical subtype in Turkish patients

Trichoscopic studies of alopecia areata are helpful in the non-invasive diagnosis and prediction of the course of the disease. The objective was to determine the relationship of trichoscopic findings in alopecia areata with disease activity, severity and clinical subtype in Turkish patients. Trichoscopic examinations of 39 patients with alopecia areata were compared with 309 alopecia patients including psoriasis (n = 31), seborrhoeic dermatitis (n = 112), female androgenetic alopecia (n = 138), male androgenetic alopecia (n = 63), female androgenetic alopecia of male pattern (n = 5), telogen effluvium (n = 22) and trichotillomania (n = 4). A χ(2) test and logistic regression analysis were used for the statistical analysis. The odds ratios were calculated by cross tabulation. There was no relationship between the alopecia areata subtype and trichoscopic findings. On the other hand, a honeycomb hyperpigmentation pattern, cumulus-like clustered white dots, white dots and black dotted pigmentation related to severe disease, while exclamation mark hairs related to mild disease. Exclamation mark hairs were found to be related to active disease while atypical red vessels and white dots were negatively related to disease activity. In our study, further characteristic trichoscopic findings were detected in alopecia areata such as clustered white dots, multi-hair follicular unit, hidden hairs and black dotted pigmentation, in addition to previous findings. Hence, it is concluded that the identification and prediction of alopecia areata might be straightforward with the help of these new signs such as activation and severity findings.

Dermoscopy findings of alopecia areata in an African-American patient

Dermoscopy has been established as an indispensable tool in the diagnosis and follow up of hair disorders. In alopecia areata, dermoscopy of active disease shows yellow dots, dystrophic hairs, as well as cadaverized (black dots) and exclamation mark hairs. Alopecia areata has been reported to occur equally among races, however, until date, there are no published data regarding dermoscopic findings in African-American patient. We report a case of scalp dermoscopy of alopecia areata in an African-American patient that shows a diffuse honeycomb-like pigmented network, few yellow dots and white dots. This case shows that skin color may affect dermoscopic findings in alopecia areata. In our African-American patient with alopecia areata dermoscopy showed a diffuse honeycomb-like pigmented network, which was previously considered characteristic for androgenic alopecia and white dots, which were considered characteristic for cicatricial alopecia. Further studies are needed to elucidate the presence of white dots in alopecia areata.

Dermatoglyphic and Other Findings in Alopecia Areata and Psoriasis

Dermatoglyphic and Other Findings in Alopecia Areata and Psoriasis