Correlation of trichoscopic findings in androgenetic alopecia and the disease severity

Abstract

Background: Androgenetic alopecia (AGA) refers to the appearance of the common nonscarring progressive patterned loss of terminal hair on the frontal scalp and/or vertex of the scalp in both men and women, seen with increasing age in genetically predisposed individuals. Until recently, a scalp biopsy was the only objective tool to diagnose and monitor the disease severity. Trichoscopy of scalp is a new noninvasive technique applied to facilitate the diagnosis of hair and scalp disorders using a manual or video dermatoscope. We found a significant difference in some of the variables such as brown peripilar sign (BPPS), white peripilar sign (WPPS), focal atrichia which may aid in the diagnosis of early and late stages of both male and female AGA along with its clinical correlation. No significant difference in the occipital area was found in all AGA patients. Aims: This study aims to study the trichoscopic findings of AGA and to correlate their relationship with disease severity in our tertiary care hospital. Settings and Design: This was a prospective, observational study. Subjects and Methods: A total of 91 patients (66 males and 25 females) of the age group between 18 and 70 years, were included in the study at the outpatient department of dermatology in 1 year. Each patient underwent a detailed general physical, systemic, and dermatological examination. The diagnosis of AGA was based on clinical grounds. The type of hair loss in each patient was recorded. Trichoscopic evaluation and capture of trichoscopic images was performed using an eScope Oitez Digital Microscope. Ethics: In accordance with the Helsinki Declaration of 1975 (revised in 2000), the study was approved by Ethical and Scientific Research committees of Care Institute of Medical Sciences, Hyderabad. Statistical Analysis Used: Statistical analysis was carried out with R-studio. Statistical significance in the difference in the outcome variables between the stages was assessed by Fisher's exact test. The statistical test was considered statistically significant at P < 0.05. Results: A positive correlation between clinical and trichoscopic findings with respect to disease severity was seen in some of the variables in our study. Both male and female AGA patients have hair shaft thickness heterogeneity as the most common feature. BPPS is seen in early grades of AGA ( P < 0.01); WPPS and focal atrichia are seen in later grades of AGA ( P < 0.01). Scalp honeycomb pigmentation was most commonly seen in all stages and is not correlated to the disease severity of AGA. Conclusion: As trichoscopy can reveal early variations in hair follicle diameter long before hair loss becomes clinically visible and has the advantage of examining larger areas in a relatively short d...

Clinico -laboratory and trichoscopic evaluation of various patterns of female baldness – A prospective case control study

“…Hu et al 9 observed this finding in 24% of FAGA patients. This disparity of findings can be due to different skin phenotypes with variation in sebaceous gland activity as well as degree of pigmentation of scalp as suggested by Ummiti A et al 8 Focal atrichia referred to as pencil erased focal loss of hair was found in 18.6% in our study nearer to that observed by Ummiti A et al 5 (24%) whereas Hu et al 9 & Zhang et al 1 reported its incidence in more than half of their patients. Zhang et al 1 correlated this finding with advancing stage o f androgenic alopecia.…”

“…White peripilar sign ( WPPS) was noticed in 44.2% of patients in the present study. Its incidence varied from 15 to 68% in various studies 1,8,9 Yellow dots(YD) were seen in 40 out of 70 pts (57%) in our study. Contrastingly its incidence was high (88%) in Ummiti A et al 8 and very low in Zhang et al 1 study(1.67%).…”

“…The mean age of presentation in the present study was 33 years (sd ±4.5). It was 37 years in a recent study by Ummita A et al 8 while it was 35.8 years in Hu et al 9 study done on Chinese population. The mean age of onset of hair fall was 26.6(sd ±2.4) y ears in our study which is nearer to the study b y Tandon S et al 2 (26.1 years).…”

Androgen-associated and androgen-independent causes of alopecia and acne in women. Literature review

“…Процес мініатюризації волосся при ВВЖТ/АГА може супроводжуватись лімфогістіоцитарною запальною інфільтрацією периінфундибулярної частини фолікула. При гістологічному дослідженні цей феномен описується як мікрозапалення, є специфічним для ВВЖТ/АГА і відрізняє її від рубцевих форм алопеції, за яких має місце більш поширене запалення і склеротичні зміни [26, 48,50].…”

Female pattern hair loss—An update

“…It can be brown sign, which is seen in early grades of FPHL and white peripilar sign, seen in later grades. [ 30 ] Yellow dots may be seen in more advanced cases, probably as a result of sebum and keratin accumulation in dilated follicles. With increased thinning of the hairs, there is greater penetration of ultraviolet radiation into the scalp and changes typical of photoaging, such as the honeycomb pigmented network, may occur.…”