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J Drugs Dermatol. 2012 Jun;11(6):753-8.

Trichoscopy of cicatricial alopecia.

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Department of Dermatology, Clinical Hospital of Ministry of Internal Affairs, Warsaw, Poland.



Trichoscopy is widely used in differential diagnosis of non-cicatricial alopecia.


The aim of this prospective study was to identify possible characteristic trichoscopy patterns of diseases leading to primary cicatricial alopecia.


Trichoscopy was performed in a total of 1,884 consecutive patients presenting with hair loss. In this group, 84 patients were diagnosed with cicatricial alopecia and 1,800 patients with non-cicatricial alopecia. Sixty healthy persons served as healthy controls. Trichoscopy was performed with the use of Fotofinder II videodermoscopy system. Following unique or characteristic features were identified: scattered dark-brown discoloration of the skin, large yellow dots and thick arborizing vessels in cutaneous (discoid) lupus erythematosus (n=20), tubular perifollicular scaling and elongated blood vessels in lichen planopilaris (n=28), minor perifollicular scaling in frontal fibrosing alopecia (n=19), tufted hairs with starburst pattern perifollicular hyperplasia in folliculitis decalvans (n=9) and large, "3D" yellow dots imposed over dystrophic hairs in dissecting cellulitis (n=8).


All patients with cicatricial alopecia trichoscopy showed white and milky-red areas lacking follicular openings. These features were not found in patients with non-cicatricial alopecia or healthy controls.


These results indicate that trichoscopy may be applied as a quick and non-invasive auxiliary method in differential diagnosis of diverse diseases leading to cicatricial alopecia, such as cutaneous lupus erythematosus, classic lichen planopilaris, frontal fibrosing alopecia, folliculitis decalvans, and dissecting cellulitis.

[Indexed for MEDLINE]

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