Ann Dermatol.  2015 Oct;27(5):539-550. 10.5021/ad.2015.27.5.539.

Trichoscopic Findings of Hair Loss in Koreans

• Park J
• Kim JI
• Kim HU
• Yun SK
• Kim SJ

• KMID: 2171454
• DOI: http://doi.org/10.5021/ad.2015.27.5.539

Abstract

BACKGROUND
Trichoscopic findings of hair loss have been well described for the differential diagnosis of alopecia; however, critical findings were not thoroughly investigated or compared among all ethnic groups, including Asians.
OBJECTIVE
We aimed to find any characteristic trichoscopic findings in Korean alopecia patients and to verify whether those findings are closely related to previously reported observations.
METHODS
Three hundred and twenty-seven patients with hair loss of various causes and 160 normal scalps were analyzed. Trichoscopic examination was performed with a polarized-light handheld dermoscope.
RESULTS
A total of 35 patterns of trichoscopic features were represented, and certain features were significantly common or observed exclusively in a particular type of alopecia as follows: yellow dots, exclamation mark hairs, and proximal tapering hairs (alopecia areata), trichoptilosis and pointed hairs (trichotillomania), corkscrew hairs, septate hyphae hairs, and comma hairs (tinea capitis), diffuse white area, fibrotic white dots, and tufting hairs (primary cicatricial alopecia), hair diameter diversity and peripilar sign (androgenetic alopecia), and short nonvellus hairs (telogen effluvium).
CONCLUSION
The characteristic trichoscopic features for the differential diagnosis of alopecia in Koreans, shown as follicular, perifollicular, and hair shaft patterns, are similar to those of Caucasians; however, the frequencies of the pigment patterns are different between Koreans and Caucasians because of the contrast effect of the skin and hair color. Therefore, racial difference should be considered in the trichoscopic evaluation for differential diagnosis.

Keyword

Alopecia; Asians; Dermoscopy; Koreans

MeSH Terms

Alopecia
Asian Continental Ancestry Group
Dermoscopy
Diagnosis, Differential
Ethnic Groups
Hair Color
Hair*
Humans
Hyphae
Scalp
Skin

Figure

• 

  Fig. 1 Trichoscopic findings of normal subjects. (A) simple red loops (yellow arrow), (B) arborizing vessels (yellow arrow), (C) pinpoint white dots (yellow arrow), (D) dirty dots (yellow arrow), and honeycomb pigmentation (dotted circle).

• 

  Fig. 2 Trichoscopic findings of localized hair loss. (A) Patchy alopecia areata: exclamation mark hairs (yellow arrow), yellow dots (yellow arrowhead), black dots (red arrow), broken hairs (red arrowhead). (B) Patchy alopecia areata: proximal tapering hairs (yellow arrow), short vellus hairs (yellow arrowhead). (C) Trichotillomania: trichoptilosis (yellow arrow), pointed hairs (yellow arrowhead), black dots, and broken hairs with different lengths. (D) Tinea capitis: septate hyphae hairs (yellow arrow), corkscrew hairs (yellow arrowhead), comma hairs (red arrow). (E) Primary cicatricial alopecia: diffuse white area (dotted circles), predominance of single hair (yellow arrows). (F) Primary cicatricial alopecia: fibrotic white dots (dotted circles), tufted hairs (yellow arrow), perifollicular scales (yellow arrowhead), diffuse erythema.

• 

  Fig. 3 Trichoscopic findings of diffuse hair loss. (A) Androgenetic alopecia: hair diameter diversity (dotted circle). (B) Androgenetic alopecia: peripilar sign (yellow arrow). (C) Telogen effluvium: short nonvellus hairs (yellow arrows), perifollicular scales (yellow arrowhead). (D) Alopecia areata incognita: proximal tapering hairs (yellow arrow), exclamation mark hairs (yellow arrowhead), black dots (red arrow).

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