Significance of dermoscopy in acute diffuse and total alopecia of the female scalp: review of twenty cases.
BACKGROUND
Acute diffuse and total alopecia of the female scalp (ADTAFS) is a new subtype of alopecia areata that is characterized by rapid progression of diffuse alopecia of the female scalp, marked female predominance and a favorable prognosis. Differential diagnosis of other types of diffuse alopecia such as female pattern hair loss (FPHL) is necessary in some cases.


OBJECTIVE
To describe dermoscopic findings of ADTAFS and to investigate the possibility of utilizing dermoscopy as a diagnostic tool for ADTAFS.


METHODS
Twenty cases of ADTAFS diagnosed by clinical and/or histological findings were examined by dermoscopy.


RESULTS
Cadaverized hairs (black dots), exclamation mark hairs (tapering hairs), broken hairs or yellow dots were seen in 18, 13, 19 and 17 out of 20 cases, respectively. One of these signs was seen in all cases (20/20). On the other hand, none of 12 cases with exclusively FPHL showed the dermoscopic features such as cadaverized hairs, exclamation mark hairs or broken hairs. Only 1 FPHL patient showed a yellow dot in the hair loss area.


CONCLUSIONS
Dermoscopy is a helpful diagnostic tool for ADTAFS, especially to distinguish it from FPHL.
Inui
Shigeki
S
Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, Suita, Japan. inui@r-derma.med.osaka-u.ac.jp
Nakajima
Takeshi
T
Itami
Satoshi
S
D000208:Acute Disease; D000279:Administration, Cutaneous; D000284:Administration, Oral; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000505:Alopecia / Q000175:diagnosis* / Q000188:drug therapy; D000506:Alopecia Areata / Q000175:diagnosis; D046169:Dermoscopy / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006197:Hair / Q000473:pathology*; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D012189:Retrospective Studies; D012536:Scalp Dermatoses / Q000175:diagnosis / Q000188:drug therapy; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones