Advertisement

Dermoscopy

  • Chinmanat Tangjaturonrusamee
Chapter

Abstract

Over the past decade, dermoscopy has seen an increase in popularity among dermatologists and other physicians for examining skin and scalp conditions. The high magnification of dermoscopy enables physicians to observe small details and subsurface skin structures which are not visible with the naked eye and therefore provides physicians with an enhanced visual diagnostic tool. Although several hair disorders like pattern hair loss or androgenetic alopecia are easy to diagnose and may not need any visual enhancement aid, there are in fact times when such diagnosis cannot be simply made.

Dermoscopy can identify the difference between scarring (cicatricial) and non-scarring alopecia. In some cases, with small alopecic patches or mild conditions, it could be difficult to make a proper diagnosis, and in these situations, dermoscopy helps to increase diagnostic certainty and reduce unnecessary biopsies.

Dermoscopy can also differentiate between trichotillomania and alopecia areata, as well as distinguishing the differences between androgenetic alopecia and telogen effluvium.

It is not only useful in clinical diagnoses, but when used by hair transplant surgeons, dermoscopy is also useful in donor hair quality and density assessments in order to achieve the desired target number of grafts in hair transplantation.

This chapter provides up-to-date information on dermoscopic findings associated with common hair and scalp disorders and its practical uses in hair transplantation.

Keywords

Dermoscopy Dermatoscopy Videodermoscopy Hair disorders 

References

  1. 1.
    Miteva M, Tosti A. Hair and scalp dermoscopy. J Am Acad Dermatol. 2012;67(5):1040–8.  https://doi.org/10.1016/j.jaad.2012.02.013. [pii] S0190-9622(12)00140-5CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Mubki T, Rudnicka L, Olszewska M, Shapiro J. Evaluation and diagnosis of the hair loss patient: part II. Trichoscopic and laboratory evaluations. J Am Acad Dermatol. 2014;71(3):431.e1–e11.  https://doi.org/10.1016/j.jaad.2014.05.008. [pii] S0190–9622(14)01435–2CrossRefGoogle Scholar
  3. 3.
    Rudnicka L, Olszewska M, Rakowska A, Czuwara J. Alopecia areata. In: Rudnicka L, Olszewska M, Rakowska A, editors. Atlas of trichoscopy dermoscopy in hair and scalp diseases. London: Springer; 2012. p. 205–20.Google Scholar
  4. 4.
    Kowalska-Oledzka E, Slowinska M, Rakowska A, Czuwara J, Sicinska J, Olszewska M, et al. ‘Black dots’ seen under trichoscopy are not specific for alopecia areata. Clin Exp Dermatol. 2012;37(6):615–9.  https://doi.org/10.1111/j.1365-2230.2012.04401.x.CrossRefGoogle Scholar
  5. 5.
    Ross EK, Vincenzi C, Tosti A. Videodermoscopy in the evaluation of hair and scalp disorders. J Am Acad Dermatol. 2006;55(5):799–806.  https://doi.org/10.1016/j.jaad.2006.04.058. [pii] S0190–9622(06)01237–0CrossRefGoogle Scholar
  6. 6.
    Rakowska A, Slowinska M, Olszewska M, Rudnicka L. New trichoscopy findings in trichotillomania: flame hairs, V-sign, hook hairs, hair powder, tulip hairs. Acta Derm Venereol. 2014;94(3):303–6.  https://doi.org/10.2340/00015555-1674.CrossRefGoogle Scholar
  7. 7.
    Hughes R, Chiaverini C, Bahadoran P, Lacour JP. Corkscrew hair: a new dermoscopic sign for diagnosis of tinea capitis in black children. Arch Dermatol. 2011;147(3):355–6.  https://doi.org/10.1001/archdermatol.2011.31. [pii] 147/3/355CrossRefPubMedGoogle Scholar
  8. 8.
    Lacarrubba F, Verzi AE, Micali G. Newly described features resulting from high-magnification dermoscopy of tinea capitis. JAMA Dermatol. 2015;151(3):308–10.  https://doi.org/10.1001/jamadermatol.2014.3313. [pii] 1938925CrossRefGoogle Scholar
  9. 9.
    Lee WS, Lee HJ, Choi GS, Cheong WK, Chow SK, Gabriel MT, et al. Guidelines for management of androgenetic alopecia based on BASP classification—the Asian Consensus Committee guideline. J Eur Acad Dermatol Venereol. 2013;27(8):1026–34.  https://doi.org/10.1111/jdv.12034.CrossRefPubMedGoogle Scholar
  10. 10.
    Inui S, Nakajima T, Itami S. Scalp dermoscopy of androgenetic alopecia in Asian people. J Dermatol. 2009;36(2):82–5.  https://doi.org/10.1111/j.1346-8138.2009.00593.x. [pii] JDE593CrossRefPubMedGoogle Scholar
  11. 11.
    de Lacharriere O, Deloche C, Misciali C, Piraccini BM, Vincenzi C, Bastien P, et al. Hair diameter diversity: a clinical sign reflecting the follicle miniaturization. Arch Dermatol. 2001;137(5):641–6. [pii] dob10023PubMedGoogle Scholar
  12. 12.
    Deloche C, de Lacharriere O, Misciali C, Piraccini BM, Vincenzi C, Bastien P, et al. Histological features of peripilar signs associated with androgenetic alopecia. Arch Dermatol Res. 2004;295(10):422–8.  https://doi.org/10.1007/s00403-003-0447-y.CrossRefPubMedGoogle Scholar
  13. 13.
    Torres F, Tosti A. Female pattern alopecia and telogen effluvium: figuring out diffuse alopecia. Semin Cutan Med Surg. 2015;34(2):67–71.  10.12788/j.sder.2015.0142.CrossRefPubMedGoogle Scholar
  14. 14.
    Rakowska A, Slowinska M, Kowalska-Oledzka E, Warszawik O, Czuwara J, Olszewska M, et al. Trichoscopy of cicatricial alopecia. J Drugs Dermatol. 2012;11(6):753–8.PubMedGoogle Scholar
  15. 15.
    Duque-Estrada B, Tamler C, Sodre CT, Barcaui CB, Pereira FB. Dermoscopy patterns of cicatricial alopecia resulting from discoid lupus erythematosus and lichen planopilaris. An Bras Dermatol. 2010;85(2):179–83. [pii] S0365-05962010000200008CrossRefPubMedGoogle Scholar
  16. 16.
    Lanuti E, Miteva M, Romanelli P, Tosti A. Trichoscopy and histopathology of follicular keratotic plugs in scalp discoid lupus erythematosus. Int J Trichology. 2012;4(1):36–8.  https://doi.org/10.4103/0974-7753.96087IJT-4-36. [pii]CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Tosti A, Torres F, Misciali C, Vincenzi C, Starace M, Miteva M, et al. Follicular red dots: a novel dermoscopic pattern observed in scalp discoid lupus erythematosus. Arch Dermatol. 2009;145(12):1406–9.  https://doi.org/10.1001/archdermatol.2009.277. [pii] 145/12/1406CrossRefPubMedGoogle Scholar
  18. 18.
    Tosti A, Miteva M, Torres F, Vincenzi C, Romanelli P. Hair casts are a dermoscopic clue for the diagnosis of traction alopecia. Br J Dermatol. 2010;163(6):1353–5.  https://doi.org/10.1111/j.1365-2133.2010.09979.x. [pii] BJD9979CrossRefPubMedGoogle Scholar
  19. 19.
    Kim GW, Jung HJ, Ko HC, Kim MB, Lee WJ, Lee SJ, et al. Dermoscopy can be useful in differentiating scalp psoriasis from seborrhoeic dermatitis. Br J Dermatol. 2011;164(3):652–6.  https://doi.org/10.1111/j.1365-2133.2010.10180.x.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute of DermatologyRajthevee, BangkokThailand

Personalised recommendations