Skip Nav Destination
Article Collection: Trichoscopy of Scarring Alopecia
Trichoscopy allows the diagnosis of cicatricial alopecia, showing a lack of follicular opening (ostia). It often indicates diseases that cause scarring. Trichoscopy is also very helpful in detecting the areas with high disease activity that are the best sites for biopsy.
However, in cicatricial alopecia, trichoscopy does not replace histopathology, which remains almost always mandatory, as it is the only way to obtain a diagnosis of certainty. Trichoscopy indicates scalp scarring when it shows a visualization of the skin lacking follicular ostia, indicating hair follicle definitive destruction with fibrosis. In mild forms of scarring alopecia, loss of follicles involves only a few follicular units, producing alopecic areas where scarring is scarcely evident to the naked eye.
Trichoscopy is particularly useful in these cases, as it allows early diagnosis and prompt initiation of treatment. Cicatricial alopecia trichoscopy can be performed with a video dermoscopy at 20-70-fold magnification and a handheld dermoscope at 10-fold magnification. Dry trichoscopy should always be done first, as perifollicular scaling, a sign highly indicative of several forms of cicatricial alopecia, becomes not visible with immersion fluid.
Trichoscopy should be performed both inside the bald spot and at the periphery; depending on the aetiology, a sign of disease activity may be present either at the centre or at the periphery of lesions. Several trichoscopy signs are common to all primary cicatricial alopecia, as they are scalp scarring and inflammation symptoms.
This article collection was edited by Michela Starace (University of Bologna, Italy) and Daniel Fernandes Melo (Rio de Janeiro State University, Brazil) published in Skin Appendage Disorders.
Conflict of Interest statement: The editors have no conflict of interest to declare.
Image: salomonus_ - stock.adobe.com
However, in cicatricial alopecia, trichoscopy does not replace histopathology, which remains almost always mandatory, as it is the only way to obtain a diagnosis of certainty. Trichoscopy indicates scalp scarring when it shows a visualization of the skin lacking follicular ostia, indicating hair follicle definitive destruction with fibrosis. In mild forms of scarring alopecia, loss of follicles involves only a few follicular units, producing alopecic areas where scarring is scarcely evident to the naked eye.
Trichoscopy is particularly useful in these cases, as it allows early diagnosis and prompt initiation of treatment. Cicatricial alopecia trichoscopy can be performed with a video dermoscopy at 20-70-fold magnification and a handheld dermoscope at 10-fold magnification. Dry trichoscopy should always be done first, as perifollicular scaling, a sign highly indicative of several forms of cicatricial alopecia, becomes not visible with immersion fluid.
Trichoscopy should be performed both inside the bald spot and at the periphery; depending on the aetiology, a sign of disease activity may be present either at the centre or at the periphery of lesions. Several trichoscopy signs are common to all primary cicatricial alopecia, as they are scalp scarring and inflammation symptoms.
This article collection was edited by Michela Starace (University of Bologna, Italy) and Daniel Fernandes Melo (Rio de Janeiro State University, Brazil) published in Skin Appendage Disorders.
Conflict of Interest statement: The editors have no conflict of interest to declare.
Image: salomonus_ - stock.adobe.com
