CLINICO-DERMOSCOPIC PROFILE OF ALOPECIA AREATA: A CROSS-SECTIONAL STUDY FROM WESTERN INDIA
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Abstract
Background : Alopecia areata is a chronic, inflammatory, non-scarring hair disorder with variable clinical presentation and severity. Its diagnosis is primarily clinical, though dermoscopy (trichoscopy) has emerged as a non-invasive tool that aids in visualization of subsurface features and reduces the need of biopsy.
Aim and Objectives : To study the various dermoscopic findings in alopecia areata and correlate clinical severity and disease activity with dermoscopic findings.
Methodology : A hospital-based cross-sectional study was conducted among treatment naïve patients of alopecia areata. Severity of Alopecia Tool and SBN (scalp, body, nail) scale was used to assess the severity and grading of the disease. Hair pull test was used to assess the disease activity. Data were analysed using Statistical Package for the Social Sciences (SPSS) for Windows.
Results : The study population (n=60) comprised 38 (63.3%) males and 22 (36.7%) females, with a mean age of 25.2 ± 8.91 years (range: 7–46 years), and the most commonly affected age group being 21–30 years (51.7%). The mean disease duration was approximately 5 months, with 75% patients showing progressive disease, 15% having no progression, and spontaneous regrowth observed in 10%; most cases involved only the scalp (88.3%), with patchy alopecia being the predominant pattern (85.0%). Majority of patients had less severe disease (83.3%) based on SBN grading, and 46.7% demonstrated a positive hair pull test indicating active disease. A significant association was observed between disease severity and dermoscopic features such as yellow dots, black dots, and tapering hair (p < 0.05), while other features showed no significant correlation. Dermoscopic features including black dots, broken hair, tapering hair, and coudability hair were significantly associated with disease activity (p < 0.05), whereas other findings did not show a significant association.
Limitation : A large sample size is required to establish significant correlation between the less studied dermoscopic featured with disease activity and severity.
Conclusion : The study highlights classical as well as less common dermoscopic features of alopecia areata. Yellow dots, black dots, and tapering hairs correlated with disease severity, while black dots, broken hairs, tapering hairs, and coudability hairs were significantly associated with disease activity. Other features such as tulip hair and Pohl–Pinkus constrictions indicate ongoing inflammatory activity.
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Dr Devyani Sapra MD
Command Hospital, Air Force Bangalore
Nisha Verma MD
Base Hospital, Delhi Cantt
Dr Saurabh Mahajan MD
Station Health Organisation, Shakurbasti
