Duque-Estrada Bruna, Tamler Carla, Sodré Celso Tavares, Barcaui Carlos Baptista, Pereira Francisco Burnier Carlos
Sociedade Brasileira de Dermatologia, Rio de Janeiro, RJ, Brasil.
An Bras Dermatol. 2010 Mar-Apr;85(2):179-83. doi: 10.1590/s0365-05962010000200008.
Dermoscopy is an important tool for the diagnosis of benign and malignant melanocytic diseases. Recently, this method has also been found to be extremely useful in the diagnosis and follow-up of alopecias.
The objective of this study was to describe dermoscopic findings in patients with clinical and histopathological characteristics of cicatricial alopecia.
A descriptive cross-sectional study was conducted in which 14 patients with cicatricial alopecia were selected based on clinical and histopathological evaluation of the scalp. The underlying cause was classic lichen planopilaris in four cases, frontal fibrosing alopecia in five and discoid lupus erythematosus in the remaining five. The patients were evaluated using videodermoscopy and conventional dermoscopy (with a handheld dermoscope), performed independently by three different examiners. Magnification ranged from 10x to 70x.
Principal findings in cases of discoid lupus erythematosus were: white patches, branching capillaries, keratin plugs and areas of reduced follicular ostia; in classic lichen planopilaris: perifollicular scales, white dots and reduced follicular ostia; and in frontal fibrosing alopecia: reduced follicular ostia, perifollicular scales, perifollicular erythema and branching capillaries. The blue-grey dots described in this paper were a novel feature in scalp dermoscopy.
The use of dermoscopy for the clinical evaluation of the scalp in cases of cicatricial alopecia improves diagnostic capacity beyond simple clinical inspection and reveals novel features of the disease.
皮肤镜检查是诊断良性和恶性黑素细胞疾病的重要工具。最近，该方法在脱发的诊断和随访中也被发现非常有用。
本研究的目的是描述具有瘢痕性脱发临床和组织病理学特征患者的皮肤镜表现。
进行了一项描述性横断面研究，根据头皮的临床和组织病理学评估选择了14例瘢痕性脱发患者。其潜在病因在4例中为经典扁平苔藓性毛囊病，5例为额部纤维性脱发，其余5例为盘状红斑狼疮。由三名不同的检查人员独立使用视频皮肤镜和传统皮肤镜（手持皮肤镜）对患者进行评估。放大倍数范围为10倍至70倍。
盘状红斑狼疮病例的主要表现为：白色斑块；分支状毛细血管；角质栓；毛囊口减少区域。经典扁平苔藓性毛囊病的表现为：毛囊周鳞屑；白色小点；毛囊口减少。额部纤维性脱发的表现为：毛囊口减少；毛囊周鳞屑；毛囊周红斑；分支状毛细血管。本文描述的蓝灰色小点是头皮皮肤镜检查中的一个新特征。
在瘢痕性脱发病例中，使用皮肤镜对头皮进行临床评估可提高诊断能力，超越简单的临床检查，并揭示该疾病的新特征。
