• Giselle MartinsEmail author
  • Isabella Doche
  • Laura Freitag
  • Maria Miteva
  • Patricia Damasco


The diagnosis of alopecia can be challenging. Usually the physician needs clinicopathologic correlation to achieve the correct diagnosis and sometimes more than one hair disease can coexist, complicating further the precise diagnosis. Alopecias are divided into scarring and nonscarring forms, from a clinical, dermoscopy, and histopathologic perspective. This basic differentiation is very important for understanding why, in some cases, the hair loss does not improve despite of the correct treatment. It is important to remember that alopecias can also be caused by infections and inflammation of the scalp, including fungal and bacterial infections and psoriasis. In this chapter, hair shaft disorders, infections, and inflammatory scalp diseases are reviewed, followed by a discussion of the acquired nonscarring alopecias and the primary cicatricial alopecias.


Alopecia Hair loss Hair shaft Black dots Yellow dots Scalp Regrowing hairs Hair casts Exclamation-mark hair Androgenetic alopecia Alopecia areata Discoid lupus erythematosus Lichen planopilaris Telogen effluvium 




Shedding of hair.

Endothrix infection 

Dermatophyte infections of the hair that invade the hair shaft and internalize into the hair cell. The hair shaft is filled with fungal branches (hyphae) and spores (arthroconidia). Endothrix infections do not fluoresce with Woods light.

Pityriasis amiantacea 

A scalp condition that causes scaling, and can occur in patches anywhere on the scalp. It is an eczematous condition of the scalp resulting in hair loss, whereby thick adherent scale infiltrates and surrounds the base of a group of scalp hairs.

Psoriasiform acanthosis 

The presence of evenly elongated, thin rete ridges with equally long dermal papillae.


A disorder that involves recurrent, irresistible urges to pull out hair from the scalp, eyebrows, or other areas of the body, despite trying to stop. Hair pulling from the scalp often leaves patchy bald spots.


Hair and scalp dermoscopy. May be performed with a handheld dermoscope. This makes it a modern, noninvasive technique.


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Copyright information

© Springer International Publishing Switzerland 2018

Authors and Affiliations

  • Giselle Martins
    • 1
    Email author
  • Isabella Doche
    • 2
    • 3
  • Laura Freitag
    • 4
  • Maria Miteva
    • 5
  • Patricia Damasco
    • 6
  1. 1.Irmandade Santa Casa de Misericódia de Porto AlegrePorto AlegreBrasil
  2. 2.University of Sao PauloSao PauloBrazil
  3. 3.University of MinnesotaMinneapolisUSA
  4. 4.Private ClinicSanta MariaBrazil
  5. 5.Department of Dermatology and Cutaneous Surgery, University of MiamiMiamiUSA
  6. 6.Dermatology, Hospital Regional Asa Norte/Private OfficeBrasiliaBrazil

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