By Antonella Tosti
Dermoscopy - the exam of the outside below distinctive illumination - has been expanding in attractiveness as a diagnostic investigational procedure, however the dermis containing hair poses particularly diversified difficulties from the surface at the remainder of the physique. This pioneering textual content examines different stipulations that may be investigated and the consequences that may be got.
This resource comprises especially commissioned art tables for ease of reference.
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Additional resources for Dermoscopy of Hair and Scalp Disorders: With Clinical and Pathological Correlations
The prevalence of alopecia areata incognita is unknown, and its diagnosis usually requires a scalp biopsy. In our experience, these patients are often misdiagnosed as having telogen effluvium, diffuse alopecia, or androgenetic alopecia. The disease usually affects women, who complain of diffuse hair thinning; alopecia is frequently more evident on the androgen-dependent areas of the scalp. The presence of numerous yellow dots and short regrowing tip-shaped miniaturized hairs (2–4 mm long) is a characteristic dermoscopic feature.
The number of hairs affected by the abnormality varies in different scalp areas. Note the breakage at the internode level. 2 (a,b) Monilethrix: hair beading may also affect vellus and intermediate hairs. 3 Monilethrix: breakage occurs at different levels from scalp emergence. 4 (a) Monilethrix: severe alopecia. 4 (b–c) Dermoscopy shows that most hairs are fractured at the scalp level. Beading is evident. 5 (a,b) Pili torti: the hair shaft is flattened and irregularly twisted. 6 Pili torti in a patient with lichen planopilaris.
13 (a,b) Histopathology of alopecia areata: nanogen and miniaturized hair follicles with dilated infundibulum containing keratin and sebaceous debris, which explain the yellow dot pattern. 14 (a,b) Congenital triangular alopecia: the patch contains vellus hairs – note the absence of yellow dots. 15 (a,b) Alopecia after an insect bite: the absence of follicular openings suggests cicatricial alopecia. qxd 10/13/07 9:07 AM Page 45 Alopecia areata incognita 4 • • • • • Diffuse hair thinning without typical patches of alopecia Usually women; thinning may be more evident on the top of the scalp Positive pull test: microscopy shows telogen hairs Dermoscopy: yellow dots, short miniaturized regrowing hairs Treatment: systemic steroids or topical steroids under occlusion Alopecia areata incognita, first described by Rebora in 1987, is a variety of alopecia areata characterized by diffuse hair shedding in the absence of typical patches.