Dermoscopic and Histopathological Correlation in Cicatricial Alopecias: Unveiling Diagnostic and Therapeutic Insights
Abstract:
Trichoscopy is dermoscopic imaging of the scalp and
hair. It is a non-invasive proven technique that aids in the diagnosis of
alopecia. It enhances the visualization of abnormalities of follicular
ostia, perifollicular skin, hair shafts and cutaneous blood vessels. In
cicatricial alopecia, loss of follicular openings, atrophy and scattered
follicular pustules or single hair follicles can be identified. Prompt diagnosis
and timely therapeutic intervention are of extreme importance as permanent hair
loss can lead to disorders related to self-esteem and psychosocial
interactions. Trichoscopy helps in early diagnosis, monitoring of disease
progression and determining the response to therapy. To determine the efficacy
of trichoscopy as a valuable and superior non-invasive method over histopathological
examination to diagnose cicatricial alopecias. This is a cross-sectional study
conducted in our hospital from September 2023 to November 2023. Patients with
cicatricial alopecia were selected. Demographic data and clinical variables in
terms of site of alopecia, type, duration, size and lesion morphology were
documented. Heine delta 30 dermoscope was employed. Both polarized and
non-polarized versions were used for examination. In this study, 16 patients
were enrolled. The causes of cicatricial alopecia were traumatic alopecia (6), lichen
planopilaris (5), discoid lupus erythematosus (4) and acne keloidalis nuchae (1).
Dermoscopy facilitated the identification of unique and characteristic features
that helped in prompt diagnosis. This was correlated with histopathological findings.
Trichoscopy of cicatricial alopecia demonstrates characteristic patterns. It is
an accurate diagnostic method that reduces the number of unnecessary biopsies
and hence it is crucial for the diagnosis and follow-up of patients.
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