Comparison of dermoscopic findings in alopecia areata, androgenetic alopecia and cicatricial alopecia

Objective: The aim of this study is to compare the specific and sensitive evidences of alopecia areata, androgenetic alopecia and cicatricial alopecia.Methods: 37 alopecia areata, 39 androgenetic alopecia and 23 cicatricial alopecia, a total of 99 patients between the ages 3-68 who were admitted to Celal Bayar University Department of Dermatology Out-patient Clinic were included in our study. An informed consent form was signed by the patients and volunteers, followed by dermoscopic examination and photography.Results: Out of 37 alopecia areata patients 10 (27%) were female, 27 (73%) were male. The ages of the AA patients ranged from 3 to 60. Out of 39 androgenetic alopecia patients 7 (17.9%) were female, 32 (82.1%) were male. The ages of the AGA patients ranged from 23 to 60. Out of 23 cicatricial alopecia patients 13 (56.5%) were female and 10 (43.5%) were male. The ages of the cicatricial alopecia patients ranged from 15 to 60. Statistical difference between the mean ages was observed in only alopecia areata and cicatricial alopecia groups. Differences in family history, sex, duration of disease and number of lesions among the patient groups were statistically significant. Skin type and hair color were not statistically significant. When dermoscopic findings were evaluated yellow dots, exclamation mark, broken hairs, black dots were more specific for alopecia areata, reduced follicular ostia, white patches, white dots, blue-grey dots, red dots, keratin plugs, branching capillaries, tufted follicul and perifollicular scales were more frequently observed in cicatricial alopecia patients. Hair diameter diversity , perifollicular pigmentation and peripilar erythema were mostly observed in AGA patients. Yellow dots with short vellus hairs were observed both in AA and AGA patients. Reduced hair diameter as a dermoscopic sign, was observed in significant ratio among alopecia areata and cicatricial alopecia patients.Conclusion: We think that our study is unique and important not only because it is the first study in literature to compare the clinical and dermoscopic findings of alopecia areata, androgenetic alopecia and cicatricial alopecia, but also evaluating the specificity and sensitivity of their dermoscopic findings. Unlike previous studies, `?yellow dots??as a dermoscopic finding was observed nearly equally both in alopecia areata and androgenetic alopecia. `Short vellus hair? was observed frequently both in androgenetic alopecia and alopecia areata. Morever, in our study we revealed `reduced hair diameter? and `honeycomb-like erythema?,which have never been reported before in previous dermoscopic and trichoscopic studies that were carried in different alopecia types. We also realized that `reduced hair diameter? was observed more in alopecia areata, while `honeycomb erythema? was only observed in cicatricial alopecia. As a result we believe that rutine use of dermoscopic and trichoscopic examination in daily dermatology practice is valuable in diagnosis and therefore treatment of all hair diseases, especially alopecias.