Penha Mariana Álvares, Müller Ramos Paulo, de Souza Vinícius, Miot Helio Amante
Department of Dermatology, Unesp Medical School, Botucatu, Brazil.
Skin Appendage Disord. 2022 May;8(3):228-235. doi: 10.1159/000520108. Epub 2021 Dec 14.
Despite the high prevalence and impact on quality of life, there are no objective methods to estimate the severity of female pattern hair loss (FPHL). Here, we aimed to develop a dermoscopic severity score for FPHL.
Cross-sectional study involving 76 women with FPHL and 12 controls. Standardized dermoscopic photos of the scalp were taken to evaluate the main findings of FPHL. The variable selection and their scores in the final model were defined by multivariate methods. Twenty participants were retested to assess the reliability, and 10 participants were tested before and after treatment for estimating its sensibility to change after 6 months.
Eight patients (11%) presented the Sinclair clinical scale grade I, 40 (53%) presented at grade II, 19 (25%) presented at grade III, and 9 (12%) presented at grades IV and V. In the multivariate exploration, the following variables were considered significant: total terminal hairs, total miniaturized hairs, brown peripilar sign, scalp honeycomb pigmentation, white peripilar sign, and yellow dots. The final model resulted in a high correlation (rho = 0.89) with the ranked clinical assessment.
An objective and reliable severity score of FPHL was developed and validated, allowing its use as an additional outcome in therapeutic trials.
尽管女性型脱发（FPHL）患病率高且对生活质量有影响，但尚无客观方法来评估其严重程度。在此，我们旨在开发一种用于FPHL的皮肤镜严重程度评分系统。
一项横断面研究，纳入76例FPHL女性患者和12例对照。拍摄头皮的标准化皮肤镜照片以评估FPHL的主要表现。通过多变量方法确定最终模型中的变量选择及其评分。对20名参与者进行复测以评估可靠性，对10名参与者在治疗前后进行测试以评估其对6个月后变化的敏感性。
8例患者（11%）为辛克莱临床分级I级，40例（53%）为II级，19例（25%）为III级，9例（12%）为IV级和V级。在多变量探索中，以下变量被认为具有显著性：终毛总数、小型化毛发总数、棕色毛周征、头皮蜂窝状色素沉着、白色毛周征和黄点。最终模型与临床评估排名具有高度相关性（rho = 0.89）。
开发并验证了一种客观可靠的FPHL严重程度评分系统，可将其用作治疗试验中的额外结局指标。
