Raj Chinmoy, Behera Dillip, Behera Debasmita, Begum Farheen, Choubey Shini
Department of Dermatology, Venereology and Leprosy, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Indian Dermatol Online J. 2025 Jul 16. doi: 10.4103/idoj.idoj_1067_24.
Alopecia areata (AA) is an unpredictable disease that manifests as rapid and patchy hair loss and may involve any hair-bearing part of the body. We used dermoscopy to compare the dermoscopic findings of AA in patients with and without poor prognostic indicators.
To compare the key variations in dermoscopic features between patients of AA with and without poor prognostic indicators.
This was a retrospective study carried out at a tertiary care teaching hospital in eastern Odisha. The study included the patients of scalp AA from October 2023 to October 2024. A total of 85 patients of AA were evaluated using the Severity of Alopecia Tool (SALT) score and Dermlite DL3 attached to iPhone 12.
A total of 85 patients with AA were included in our study (male: female ratio ~ 2:1). The mean (± standard deviation) age of patients was 26.61 ± 9.82 years. The mean duration of the disease was 5.98 ± 11.74 months. Patchy AA was the most common. The most common dermoscopic feature observed was yellow dots (83.5%), followed by broken hairs (65.9%), black dots (51.8%), vellus hairs (51.8%), tapering hairs (50.6%), and coudability hairs (22.4%). Patients with poor prognostic markers had a substantially higher SALT score (34.99 ± 37.21) compared to those without (10.75 ± 14.08), with P = 0.002. A statistically significant high SALT score was recorded in patients with disease duration >3 months. The dermoscopic features that were significantly more frequent in patients having poor prognostic factors were yellow dots (P = 0.000), black dots (P = 0.02), broken hairs (P = 0.03), and coudability hairs (P = 0.000), while in patients without poor prognosis, vellus hairs (P = 0.005) were more commonly seen. The finding of tapering hair (P = 0.1) was not found to be significantly associated with either group.
Retrospective nature of the study and not assessing dermoscopic response to treatment.
Ours is the first study to emphasize the comparison of dermoscopic features of AA in patients with and without poor prognostic indicators. Yellow dots, black dots, broken hairs, and coudability hairs were associated with adverse prognosis, while vellus hair indicated a favorable outcome. Identifying these key dermoscopic markers can help to assess the disease severity, potentially refine prognostic assessments, and guide treatment decisions.
斑秃（AA）是一种不可预测的疾病，表现为迅速出现的斑片状脱发，可累及身体任何有毛发的部位。我们使用皮肤镜比较了有和没有不良预后指标的斑秃患者的皮肤镜检查结果。
比较有和没有不良预后指标的斑秃患者皮肤镜特征的关键差异。
这是一项在奥里萨邦东部一家三级护理教学医院进行的回顾性研究。该研究纳入了2023年10月至2024年10月的头皮斑秃患者。总共85例斑秃患者使用脱发严重程度工具（SALT）评分和连接到iPhone 12的Dermlite DL3进行评估。
我们的研究共纳入85例斑秃患者（男女比例约为2:1）。患者的平均（±标准差）年龄为26.61±9.82岁。疾病的平均持续时间为5.98±11.74个月。斑片状斑秃最为常见。观察到的最常见皮肤镜特征是黄点（83.5%），其次是断发（65.9%）、黑点（51.8%）、毳毛（51.8%）、锥形发（50.6%）和卷曲发（22.4%）。与没有不良预后指标的患者相比，有不良预后指标的患者SALT评分显著更高（34.99±37.21），而无不良预后指标的患者SALT评分为（10.75±14.08），P = 0.002。疾病持续时间>3个月的患者记录到具有统计学意义的高SALT评分。在有不良预后因素的患者中显著更频繁出现的皮肤镜特征是黄点（P = 0.000）、黑点（P = 0.02）、断发（P = 0.03）和卷曲发（P = 0.000），而在没有不良预后的患者中，毳毛（P = 0.005）更常见。锥形发的发现（P = 0.1）与两组均无显著关联。
研究的回顾性性质以及未评估皮肤镜下的治疗反应。
我们的研究首次强调比较有和没有不良预后指标的斑秃患者的皮肤镜特征。黄点、黑点、断发和卷曲发与不良预后相关，而毳毛提示预后良好。识别这些关键的皮肤镜标志物有助于评估疾病严重程度，可能完善预后评估并指导治疗决策。
