Chiramel Minu Jose, Sharma Vinod Kumar, Khandpur Sujay, Sreenivas Vishnubhatla
Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Indian J Dermatol Venereol Leprol. 2016 Nov-Dec;82(6):651-658. doi: 10.4103/0378-6323.183636.
Trichoscopy is an office tool used in the diagnosis of alopecia but its utility has not been assessed.
To compare the trichoscopic characteristics of different types of alopecia, identify features of diagnostic value, and to determine the utility of trichoscopy in the diagnosis of alopecia.
A descriptive cross-sectional study was performed in patients with alopecia. After clinical assessment and relevant investigations, trichoscopy was performed using a non-polarized trichoscope (×10). The utility of trichoscopy in difficult cases of alopecia was assessed statistically.
One hundred and twenty patients of alopecia (90 non-cicatricial, 30 cicatricial) were recruited. The diagnosis was made on the basis of a detailed history and clinical examination, and confirmed by biopsy and relevant investigations in difficult cases. Yellow dots (63.3%) were the most common trichoscopic feature followed by thin hair (40.8%). Among the 21 difficult cases of alopecia, trichoscopy was diagnostic in 19 (90.5%). Statistically significant features on intergroup comparison included black dots (Fischer's exact test, P< 0.001), cadaverized hair (P = 0.024), exclamation mark hair (P < 0.001) in alopecia areata; diameter diversity more than 20% (P < 0.001) and thin hair (P < 0.001) in androgenetic alopecia; broken hair of different lengths (P < 0.001), frayed hair (P < 0.001), split ends (P < 0.001) in trichotillomania; comma hair (P < 0.001) in tinea capitis and arborizing blood vessels in discoid lupus erythematosus (P = 0.012).
The small number of patients in some types of alopecia was a limiting factor.
Trichoscopy is useful in the differential diagnosis of alopecia. Among the various trichoscopic findings, those of diagnostic value were identified.
毛发镜检是一种用于脱发诊断的门诊工具，但其效用尚未得到评估。
比较不同类型脱发的毛发镜检特征，识别具有诊断价值的特征，并确定毛发镜检在脱发诊断中的效用。
对脱发患者进行描述性横断面研究。在临床评估和相关检查后，使用非偏振毛发镜（×10）进行毛发镜检。对毛发镜检在疑难脱发病例中的效用进行统计学评估。
招募了120例脱发患者（90例非瘢痕性，30例瘢痕性）。诊断基于详细的病史和临床检查，并在疑难病例中通过活检和相关检查得以证实。黄色小点（63.3%）是最常见的毛发镜检特征，其次是细发（40.8%）。在21例疑难脱发病例中，毛发镜检诊断出19例（90.5%）。组间比较具有统计学意义的特征包括斑秃中的黑点（Fisher精确检验，P<0.001）、尸体样毛发（P = 0.024）、惊叹号样毛发（P < 0.001）；雄激素性脱发中直径差异超过20%（P < 0.001）和细发（P < 0.001）；拔毛癖中不同长度的断发（P < 0.001）、磨损毛发（P < 0.001）、发梢分叉（P < 0.001）；头癣中的逗号样毛发（P < 0.001）以及盘状红斑狼疮中的树枝状血管（P = 0.012）。
某些类型脱发的患者数量较少是一个限制因素。
毛发镜检在脱发的鉴别诊断中有用。在各种毛发镜检结果中，识别出了具有诊断价值的结果。
