Alopecia <scp>areata‐like</scp> pattern: A new unifying concept

Thompson, Curtis T.; Kolivras, Athanassios

doi:10.1111/cup.13864

Cited by 4 publications

(6 citation statements)

References 30 publications

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“…The AA-like pattern of patchy nonscarring LE alopecia is a histopathological description characterized by a deep inflammatory infiltrate, increased catagen/telogen count, and pigmented casts. The same can be found in DLE with deep follicular involvement [1,7].…”

Section: Discussion/conclusionsupporting

confidence: 72%

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Epidemiological, Clinical, Trichoscopic, and Histopathological Features of Lupus Erythematous Mimicking Alopecia Areata: A Multicenter Retrospective Study

Melo

Ramos

Iorizzo

et al. 2022

Skin Appendage Disord

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Introduction: All types of lupus erythematosus (LE) may cause hair loss. Nonscarring alopecia was correlated with systemic LE, based on its high specificity. Discoid LE can also appear as nonscarring patches in early stages. Patchy alopecia LE-specific may also mimic alopecia areata (AA) – which can co-occur with LE. The distinction is fundamental to early diagnosis and effective treatment. This study aims to analyze clinical, epidemiological, trichoscopic, and histopathological features of patients with patchy LE-specific alopecia, nonscarring type, mimicking AA. Methods: This is a multicentric retrospective study. We reviewed the medical records of patients with a confirmed diagnosis of LE mimicking AA. Results: Ten patients were included (90% female) with a mean age of 45.9 years. Clinically, 60% showed erythema and 70% presented incomplete hair loss. The most common trichoscopic findings were interfollicular arborizing vessels (90%) and scattered brown discoloration (80%). On histopathology, perivascular inflammation (85.7%), peribulbar lymphocytes (85.7%), and dermal pigment incontinence (71.4%) were present in most cases. Discussion/Conclusion: Trichoscopy was found as an essential first step for the patchy alopecia diagnosis, enabling to differentiate LE from AA. Putting it mildly, trichoscopy raises the suspicion that leads to a biopsy, increasing the diagnostic accuracy with better outcome for patients.

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Section: Discussion/conclusionsupporting

confidence: 72%

“…Some of the most common trichoscopic findings observed were previously related to LE, as interfollicular arborizing vessels (90%) and scattered brown discoloration (80%) [7, 8]. Less commonly, trichoscopy findings classically related to AA were observed, as yellow dots (30%) and circular hair (20%).…”

Section: Resultsmentioning

confidence: 99%

Epidemiological, Clinical, Trichoscopic, and Histopathological Features of Lupus Erythematous Mimicking Alopecia Areata: A Multicenter Retrospective Study

Melo

Ramos

Iorizzo

et al. 2022

Skin Appendage Disord

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“…Both AA and AGA impose a tremendous psychological burden on patients, decreasing their quality of life 4–6 . Although the hair follicle opening, hair shaft morphology, skin capillaries, and hair root morphology are observed by hair microscopy, 7 the growth state of hair follicles within the scalp cannot be detected using hair microscopy. Studies on the differential diagnosis of tertiary AGA and severe alopecia areata used dermoscopy 8–10 .…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and differential diagnosis of tertiary androgenetic alopecia with severe alopecia areata based on high‐resolution MRI

Wang

Zhu

et al. 2023

Skin Research and Technology

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Background and aim:No previous study investigated the anatomical changes of the scalp and hair follicles between tertiary androgenetic alopecia and severe alopecia areata using high-resolution magnetic resonance imaging (HR-MRI). This study aimed to explore the value of HR-MRI in assessing alopecia.Materials and methods: Forty-eight people were included in this study. The imaging indicators of the vertex and occipital scalp were recorded and compared. The logistic regression model was developed for the indicators that differed between tertiary androgenetic alopecia and severe alopecia areata. The receiver-operating characteristic (ROC) curve was used to assess the diagnostic efficacy of the model for tertiary androgenetic alopecia and severe alopecia areata.Results: At the vertex, the thickness of the subcutaneous tissue layer, follicle depth, relative follicle depth, total number of follicles within a 2-cm distance, and number of strands reaching the middle and upper third of the subcutaneous fat layer within a 2-cm distance were statistically different between patients with tertiary androgenetic alopecia, those with severe alopecia areata, and healthy volunteers (p < 0.05). The logistic regression model suggested that the subcutaneous tissue layer thickness was important in discriminating tertiary androgenetic alopecia from severe alopecia areata.The ROC curve showed that the area under the curve, sensitivity, specificity, and best cutoff values of the subcutaneous tissue layer were 0.886, 94.4%, 70%, and 4.31 mm, respectively.Conclusions: HR-MRI can observe the changes in anatomical structures of the scalp and hair follicles in patients with alopecia. HR-MRI can be applied to the differential diagnosis of tertiary androgenetic alopecia and severe alopecia areata.

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“…Notably, these trichoscopic signs are features of an AA-like pattern. 4 Black and white terminal hair was subsequently reported in all patients. 5 Permanent alopecia has been reported in a 6-year-old child treated with radiotherapy for a medulloblastoma.…”

mentioning

confidence: 95%

Anagen effluvium and the role of trichoscopy

Starace

Orlando

Bruni

et al. 2021

Clin Experimental Derm

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Black dots, broken hairs, flame hairs, yellow dots, Pohl-Pinkus constrictions, tulipoid hairs Circle hairs, pigtail hairs, vellus-like hairs, black and white terminal hairs Targeted therapy Black dots, broken hairs, flame hairs, yellow dots Circle hairs, pigtail hairs, vellus-like hairs Radiotherapy Black dots, broken hairs, flame hairs, yellow dots Circle hairs, pigtail hairs, vellus-like hairs, white cicatricial patches Pemphigus vulgaris Dotted vessels, yellow haemorrhagic crusts, diffuse scaling, erythema Circle hairs, pigtail hairs, vellus-like hairs Localized traumas, infections Black dots, broken hairs, flame hairs, yellow dots Circle hairs, pigtail hairs, vellus-like hairs Alopecia areata Black dots, exclamation-mark hairs, yellow dots, pseudomonilethrix Circle hairs, pigtail hairs, vellus-like hairs, white/pigmented terminal hairs

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Alopecia areata‐like pattern: A new unifying concept

Cited by 4 publications

References 30 publications

Epidemiological, Clinical, Trichoscopic, and Histopathological Features of Lupus Erythematous Mimicking Alopecia Areata: A Multicenter Retrospective Study

Epidemiological, Clinical, Trichoscopic, and Histopathological Features of Lupus Erythematous Mimicking Alopecia Areata: A Multicenter Retrospective Study

Diagnosis and differential diagnosis of tertiary androgenetic alopecia with severe alopecia areata based on high‐resolution MRI

Anagen effluvium and the role of trichoscopy

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