Scalp dermatoscopic findings in androgenetic alopecia and their relations with disease severity

Abstract

Background: Clinicians are searching for new methods to diagnose and predict the course of androgenetic alopecia noninvasively.

Objective: Our aim is to evaluate trichoscopic findings and their relations with disease severity in androgenetic alopecia.

Methods: The videodermatoscopic findings of 143 female and 63 male patients with androgenetic alopecia were compared with each other, with those of healthy subjects (n=100), and with those of patients with other nonscarring alopecias (n=208). Mann-Whitney U-test, χ(2) analyses, and logistic regression analysis were used for statistical analysis.

Results: No statistically significant relation was found between trichoscopic findings and severity in male androgenetic alopecia (MAGA) on the basis of the modified Hamilton Norwood scale (among 7 degrees); however, multihair follicular unit and perifollicular pigmentation were related to low severity whereas white dots, honeycomb pattern pigmentation, and brown dots were related to high severity. On the other hand, according to the Ludwig classification, arborizing red lines were related to low severity and brown dots were related to high severity, whereas there was no difference in stages between the Ebling and Olsen classifications in female androgenetic alopecia (FAGA). In the characteristic trichoscopic findings in this study, perifollicular pigmentation was found as a normal feature of the scalp, whereas multihair follicular unit and honeycomb pigment pattern, which were previously considered as normal features, were observed to be related to androgenetic alopecia.

Conclusion: No relation was found between MAGA severity and trichoscopic findings, as well as between FAGA severity according to different disease severity classifications and trichoscopic findings.

Keywords: Androgenetic alopecia; Dermoscopy; Trichoscopy.

Fig. 1

(A) Perifollicular pigmentation, brown dots, white dots, miniaturization, and hair diameter diversity in a 65-year-old patient with male androgenetic alopecia Hamilton Norwood stage 5. (B) Miniaturization, hair diameter diversity, white dots, and perifollicular pigmentation in a 25-year-old patient with female androgenetic alopecia (FAGA) Ludwig stage 1. (C) Perifollicular pigmentation, glomerular, and signet ring vessel (in green circle), hidden hairs, miniaturization, and hair diameter diversity in a 23-year-old FAGA Ludwig stage 1 patient with seborrheic dermatitis. (D) Perifollicular pigmentation, multihair follicular unit, miniaturization, and hair diameter diversity in a 32-year-old FAGA Ludwig stage 1 patient.