The Importance of Trichoscopy in Clinical Practice

Abstract

Trichoscopy corresponds to scalp and hair dermoscopy and has been increasingly used as an aid in the diagnosis, follow-up, and prognosis of hair disorders. Herein, we report selected cases harbouring scalp or hair diseases, in whom trichoscopy proved to be a valuable tool in their management. A review of the recent literature on this hot topic was performed comparing the described patterns with our findings in clinically common conditions, as well as in rare hair shaft abnormalities, where trichoscopy may display pathognomonic features. In our view, trichoscopy represents a valuable link between clinical and histological diagnosis. We detailed some trichoscopic patterns, complemented with our original photographs and our insights into nondescribed patterns.

Trichoscopy Simplified

“…Presence of empty hair follicles and decreased hair density, one follicular hair unit dominance ( Fig. 3) and perifollicular discolouration (perpilar sign) and upright short hair re-growth [5,9]. TE is a diagnosis of exclusion.…”

“…It has been suggested that a diversity of 20% is diagnostic of FAGA [3,5,10]. White dots were seen and are suggested to be related to severe disease stage.…”

“…Trichoscopy is a quick, easy, priceless, novel, efficient, and a non-invasive device, which can save time and money to achieve a clear-cut diagnosis and enable treatment to start [4]. It assists visualization of the surface and beneath constitutions and colour outlines of scalp and hair [5]. It offers rapid appreciation of scalp and hair disorders, and advances diagnostic accuracy.…”

“…. Anisotrichosis, due to miniaturization of the hair follicles; more than 20% of hair shafts[5,6,20].…”

Trichoscopy of Hair Shaft: White Nodules

“…It represents a valuable noninvasive and low-cost method, still underutilized, which uses video dermoscopy of hair and scalp at higher magnifications (20-160) [2], and that has been increasingly used as an aid in the diagnosis, follow-up and prognosis of hair disorders [3].…”