Trichostasis spinulosa of the scalp mimicking Alopecia Areata black dots

Abstract

Alopecia areata is a common autoimmune disorder that leads to nonscarring hair loss. Black dots, also called comedo-like cadaver hairs, can be found in almost 50% of alopecia areata patients and indicate disease activity. Trichostasis spinulosa is a follicular disorder resulting from the retention of numerous hairs surrounded by a keratinous sheath in dilated follicles. Trichostasis spinulosa is a relatively common but underdiagnosed disorder of hair follicles. Here, we describe a man with alopecia areata of the eyebrows, androgenetic alopecia and trichostasis spinulosa at the vertex and show how dermoscopy can be useful in distinguishing black dots from Trichostasis spinulosa lesions.

Dermoscopic Findings and Their Therapeutic Implications in Trichostasis Spinulosa: A Retrospective Study of 306 Patients

“…DBH or dermoscopic black comedones are not the same as black dots in trichoscopy. The latter is caused by fractured hairs at the level of skin emergence [9], while the former are follicular openings filled with oxidized melanin and sebum, which are easily extracted by pressure expression.…”

Trichostasis spinulosa: An unusual diagnosis presenting as a double lower eyelid

“…Among the noninvasive diagnostic procedures, use of dermoscopy has been proved to be useful which shows the classic hair tufts inside hair openings. [ 8 ] In this case, the cosmetic predicament was the main concern of the patient for which surgical excision was done, and diagnosis was confirmed on histopathological examination.…”

Trichostasis spinulosa: An entity with cosmetic concern

“…[21] e pruritic type seen in young adults is the second variant and is characterized by widespread distribution, extrafacial involvement, and in association with other follicular hyperkeratotic disorders, chronic renal failure, and benign cutaneous tumors. [15,21,22] Uncommon presentations include involvement of scalp mimicking black dots of alopecia areata, [11,23] involvement of axilla, [24] lower eyelid, [7] nevoid pattern [25] , and generalized distribution in a case with chronic renal failure. [22]…”