Ardigò Marco, Tosti Antonella, Cameli Norma, Vincenzi Colombina, Misciali Cosimo, Berardesca Enzo
San Gallicano Dermatologic Institute, IRCCS, Rome, Italy.
Arch Dermatol. 2011 Jan;147(1):61-4. doi: 10.1001/archdermatol.2010.288.
The presence of yellow dots is a characteristic dermoscopic finding in alopecia areata. The aim of this study was to investigate the yellow dot pattern observed at dermoscopy in alopecia areata with reflectance confocal microscopy (RCM) and correlate RCM findings with pathological features.
Six patients affected by alopecia totalis entered the study. Patients were first submitted to scalp dermoscopy, which was followed by RCM examination of the same area. After RCM, a 5-mm punch biopsy specimen was also taken. Dermoscopic findings showed the yellow dot pattern in all patients, with round or polycyclic yellow-pink dots often containing miniaturized or broken hair shafts. At RCM, a Vivablock mosaic taken at the level of the spinous layer showed striking reduction of follicular adnexal structures and empty lumina containing highly refractile material corresponding to the yellow dots seen on dermoscopy. The pathological features showed that the yellow dots correspond to the dilated infundibula of the velluslike anagen and telogen follicles that characterize the chronic phase of alopecia areata.
The RCM study of the yellow dot pattern showed a good correlation with the dermoscopic and pathological findings and confirms that the yellow dots correspond to inefficient follicular structures that often contain hair remnants.
黄点的存在是斑秃的一种特征性皮肤镜表现。本研究的目的是通过反射式共聚焦显微镜（RCM）研究斑秃皮肤镜下观察到的黄点模式，并将RCM结果与病理特征相关联。
6例全秃患者进入本研究。患者首先接受头皮皮肤镜检查，随后对同一区域进行RCM检查。RCM检查后，还取了5毫米的钻孔活检标本。皮肤镜检查结果显示所有患者均有黄点模式，圆形或多环状黄粉色点，通常包含小型化或断裂的毛干。在RCM检查中，在棘层水平获取的Vivablock镶嵌图显示毛囊附属结构显著减少，管腔空虚，含有高折射物质，对应于皮肤镜下所见的黄点。病理特征显示，黄点对应于毳毛样生长期和休止期毛囊的扩张漏斗部，这是斑秃慢性期的特征。
对黄点模式的RCM研究显示与皮肤镜和病理结果有良好的相关性，并证实黄点对应于通常含有毛发残余物的低效毛囊结构。
