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    Tricho S

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    Andri Saik
    Trichoscopy, or dermatoscopy of the scalp, can be used as a tool to diagnose pattern hair loss (PHL). Key features seen in trichoscopy of PHL are diversity of hair shaft diameter, peripilar sign (fine scales surrounding hairs), and empty follicles. Additional findings may include a honeycomb pigment pattern and arborizing red lines. Studies have shown that trichoscopy is superior to trichogram for diagnosing PHL, especially in early cases, as it can detect a diversity of hair shaft diameters above 20%. Diagnostic criteria have been proposed based on trichoscopy findings of empty follicles, hair thickness differences, and number of thin hairs in frontal vs occip

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    Tricho S

    Uploaded by

    Andri Saik
    51 views1 page
    Trichoscopy, or dermatoscopy of the scalp, can be used as a tool to diagnose pattern hair loss (PHL). Key features seen in trichoscopy of PHL are diversity of hair shaft diameter, peripilar sign (fine scales surrounding hairs), and empty follicles. Additional findings may include a honeycomb pigment pattern and arborizing red lines. Studies have shown that trichoscopy is superior to trichogram for diagnosing PHL, especially in early cases, as it can detect a diversity of hair shaft diameters above 20%. Diagnostic criteria have been proposed based on trichoscopy findings of empty follicles, hair thickness differences, and number of thin hairs in frontal vs occip

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    Trichoscopy, or dermatoscopy of the scalp, can be used as a tool to diagnose pattern hair loss (PHL). Key features seen in trichoscopy of PHL are diversity of hair shaft diameter, peripilar sign (fine scales surrounding hairs), and empty follicles. Additional findings may include a honeycomb pigment pattern and arborizing red lines. Studies have shown that trichoscopy is superior to trichogram for diagnosing PHL, especially in early cases, as it can detect a diversity of hair shaft diameters above 20%. Diagnostic criteria have been proposed based on trichoscopy findings of empty follicles, hair thickness differences, and number of thin hairs in frontal vs occip

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    © All Rights Reserved
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    Download as pdf or txt
    51 views1 page

    Tricho S

    Uploaded by

    Andri Saik
    Trichoscopy, or dermatoscopy of the scalp, can be used as a tool to diagnose pattern hair loss (PHL). Key features seen in trichoscopy of PHL are diversity of hair shaft diameter, peripilar sign (fine scales surrounding hairs), and empty follicles. Additional findings may include a honeycomb pigment pattern and arborizing red lines. Studies have shown that trichoscopy is superior to trichogram for diagnosing PHL, especially in early cases, as it can detect a diversity of hair shaft diameters above 20%. Diagnostic criteria have been proposed based on trichoscopy findings of empty follicles, hair thickness differences, and number of thin hairs in frontal vs occip

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    Trichoscopy as a Tool in Pattern Hair Loss

    Prof. Ralph M. Trüeb, M.D., Center for Dermatology and Hair Diseases, Bahnhofplatz 1A,
    CH-8304 Zurich-Wallisellen, Switzerland, www.derma-haarcenter.ch

    Dermoscopy is a non-invasive diagnostic tool that permits recognition of morphologic


    structures not visible to the naked eye. Dermatologists involved in the management of and
    scalp disorders have discovered dermoscopy to also be useful in their daily clinical practice.
    Scalp dermoscopy or trichoscopy is not only helpful for the diagnosis of hair and scalp
    disorders, but it can also give clues about the disease stage and progression Structures which
    may be visualized by trichoscopy include hair shafts of different types (vellus, terminal,
    intermediate, pathologic), follicular patterns (white, yellow, and black dots), vascular patterns,
    abnormalities of pigmentation, scaling, and exogenous materials. Using trichoscopy, signature
    patterns are seen in a range of scalp and hair conditions. Trichoscopic features of pattern hair
    loss (PHL) are diversity of hair shaft diameter, peripilar sign, and empty follicles, additional
    findings may be honeycomb pigment pattern, and arborizing red lines. Among the methods
    for diagnosis of PHL, the trichogram reflects low-grade telogen effluvium of the affected
    frontal and centroparietal scalp, while the trichoscopic finding of anisotrichosis relates to the
    presence of hairs with different caliber as a consequence of progressive hair follicle
    miniaturization. Originally Tosti et al suggested that diversity of hair shaft diameter > 20% is
    diagnostic of PHL. More recently, Rakowska et al proposed more sophisticated diagnostic
    criteria for diagnosis of PHL in women based on trichoscopic imaging. Major criteria are: (1)
    ratio of more than four empty follicles in four images (at 70-fold magnification) in the frontal
    area, (2) lower average thickness in the frontal area compared to the occiput and (3) more
    than 10% of thin hairs (< 0.03 mm in diameter) in the frontal area. Minor criteria were: (1)
    increased frontal to occipital ratio of single-hair pilosebaceous units, (2) vellus hairs, and (3)
    peripilar signs. Fulfillment of two major criteria or of one major and two minor criteria allow
    diagnosis of PHL in women with a 98% specificity. We performed a study to evaluate the
    value of trichoscopy as compared to the trichogram for the diagnosis of PHL in women, and
    found that trichoscopy is a valuable and superior method to the trichogram for diagnosis of
    PHL in women, especially in early cases, with the highest yield irrespective of the suggested
    cut-off of 20% diversity of hair shaft. Presence of peripilar signs might point to perifollicular
    microinflammation and fibrosis rendering PHL less responsive to standard treatment, while
    presence of honeycomb pigment pattern and of arborizing red lines relate to the extent of
    UVR exposure and possibly damage. Ultimately, examination of the scalp by dermoscopy can
    reassure patients with PHL that they have received a thorough scalp examination, since
    patients with hair loss are very distressed and often feel that they are not properly examined.

    Further Reading
    Galliker NA, Trüeb RM. Value of trichoscopy versus trichogram for diagnosis of female
    androgenetic alopecia. Int J Trichology. 2012 Jan;4(1):19-22.

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