Dermoscopic Findings of Scalp Aplasia Cutis Congenita

Abstract

Aplasia cutis congenita (ACC) is a rare disease characterized by congenital absence of skin, affecting preferentially the scalp. Diagnosis is made clinically; however, recent studies have shown that dermoscopy can be a useful tool for the diagnosis and differentiation from sebaceous nevus. The clinical findings include a shiny atrophic alopecic patch associated with dermoscopic findings of absent follicular openings, thicker vessels and a distinct collar hypertrichosis. We report 2 cases of alopecia presenting from birth. At dermoscopy, the absence of follicular openings and the increase in the caliber of vessels led us to establish the diagnosis of ACC.

Dermoscopy of Aplasia Cutis Congenita: A Case Report and Review of the Literature

“…Dermoscopic images at hair-bearing margins reveal a translucent epidermis, a visible vascular network, and hair bulbs arranged radially along the margins of alopecia [2,3]. Additional dermoscopic findings have included absent follicular openings, thicker vessels, and distinct collar hypertrichosis [2]. Hair bulbs have been shown on trichoscopy, visible through a semi-translucent epidermis [3].…”

“…Recent published reports demonstrate the emerging use of dermoscopy and trichoscopy as a valuable tool for diagnosing ACC [2][3][4][5]. Dermoscopic images at hair-bearing margins reveal a translucent epidermis, a visible vascular network, and hair bulbs arranged radially along the margins of alopecia [2,3]. Additional dermoscopic findings have included absent follicular openings, thicker vessels, and distinct collar hypertrichosis [2].…”

“…ACC can be differentiated from other types of congenital or acquired alopecia, such as triangular temporal alopecia, which shows presence of vellus hairs only in affected sites; alopecia areata, which shows black dots, yellow dots, and exclamation hairs; tinea capitis, which shows coiled or comma shaped hairs; and trichotillomania, which shows broken hairs and flame hairs [3]. Membranous ACC can also be distinguished from nevus sebaceous by visualizing a lack of skin appendages and a translucent appearance [2]. While biopsy for histopathologic evaluation can be performed to diagnose ACC, showing a thin layer of dermal collagen without epidermis or adnexal structures, biopsies can be avoided if the diagnosis can be made clinically.…”

Dermoscopic characteristics of membranous aplasia cutis congenita: Report of 56 cases

“…In recent years, the usefulness of trichoscopy (scalp dermoscopy) has been reported for hair loss diseases. The center of skin lesions of MACC mainly manifests in hair follicle openings and hair deficiency, and translucent epidermis is associated with the edge of skin lesions, where dermatrophy‐induced vascular network is visible, and hair root and hair bulb are arranged along the margins 3–6 . Due to the abnormal epidermal development, resulting in thinning of skin, MACC appeared translucent under dermoscopy.…”

“…[1][2][3] Skin lesions with MACC have various manifestations with obvious dermoscopic characteristics, including hair follicle openings and hair deficiency in the center of skin lesions, translucent epidermis, and hair root and hair bulb arranged along the margins of skin lesion. [3][4][5][6] Dermoscopic manifestations of MACC in 56 cases were with red. Among these 44 (78.6%) cases who were found with hair root and hair bulb along the margin of skin lesions, 21 (37.5%) cases had hair root and hair bulb arranged radially along skin lesions, 18 (32.1%) cases had linear-or arc-arranged lesions, and five (8.9%) cases had disorderly arranged lesions.…”