Tosti Antonella, Torres Fernanda, Misciali Cosimo, Vincenzi Colombina, Starace Michela, Miteva Mariya, Romanelli Paolo
Department of Dermatology, University of Bologna, Via Massarenti 1, 40138, Bologna, Italy.
Arch Dermatol. 2009 Dec;145(12):1406-9. doi: 10.1001/archdermatol.2009.277.
Scalp dermoscopy plays an important role in the diagnosis of hair and scalp disorders, and specific dermoscopic patterns have recently been associated with several disorders causing noncicatricial alopecia, such as androgenetic alopecia, alopecia areata, trichotillomania, and tinea capitis.
We describe the morphologic and pathologic features of a new dermoscopic pattern, referred to as "follicular red dots," that was found in scalp lesions of 5 patients with active discoid lupus erythematosus (DLE). Follicular red dots appear as erythematous polycyclic, concentric structures, with a diameter ranging from 0.16 to 0.47 mm, regularly distributed in and around the follicular ostia. In the pathologic findings, red dots correspond to widened infundibula plugged by keratin and surrounded by dilated vessels and extravasated erythrocytes. Retrospective blinded evaluation of the dermoscopic images of 155 patients with cicatricial alopecia suggests that follicular red dots are a specific feature of DLE because the pattern was not identified in the images of cicatricial alopecia resulting from other diseases.
The follicular red dot pattern is a specific feature of scalp lesions of active lupus erythematosus of the scalp. Recognition of this distinctive dermoscopic pattern may help the clinician to differentiate DLE from other diseases causing cicatricial alopecia.
头皮皮肤镜检查在毛发和头皮疾病的诊断中发挥着重要作用，最近特定的皮肤镜表现已与多种导致非瘢痕性脱发的疾病相关联，如雄激素性脱发、斑秃、拔毛癖和头癣。
我们描述了一种新的皮肤镜表现的形态学和病理学特征，称为“毛囊红点”，在5例活动性盘状红斑狼疮（DLE）患者的头皮病变中发现。毛囊红点表现为红斑性多环、同心结构，直径范围为0.16至0.47毫米，规则分布于毛囊口及其周围。在病理检查结果中，红点对应于被角蛋白堵塞且被扩张血管和外渗红细胞围绕的增宽漏斗部。对155例瘢痕性脱发患者的皮肤镜图像进行回顾性盲法评估表明，毛囊红点是DLE的一个特异性特征，因为在其他疾病导致的瘢痕性脱发图像中未发现该表现。
毛囊红点表现是头皮活动性红斑狼疮头皮病变的特异性特征。识别这种独特的皮肤镜表现可能有助于临床医生将DLE与其他导致瘢痕性脱发的疾病区分开来。
