utility of trichoscopy in various types of alopecia - a cross-sectional study

Background: alopecia is one of the most common reasons for consulting dermatologists, and the clinical diagnosis can become confusing. in light of the inclination of patients and doctors toward non-invasive diagnosis, along with the vogue of non-invasive diagnostic modalities, trichoscopy has become a promising tool. objectives: to study various dermoscopic patterns of alopecia. methods: after obtaining informed consent, this cross-sectional study was conducted among 100 patients with alopecia attending a tertiary health care center. a detailed history and clinical photographs were taken. relevant investigations were done whenever indicated. dermoscopy was done using illuco ids- 1100 with 10x magnification. statistical analysis used: data was analyzed using spss 22 version software. the chi-square test, kolmogorov-smirnov test, and shapiro-wilk test was used for assessment with a significant p-value of < 0.05. kappa statistics were used to assess agreement between the two modalities. results: overall, vellus hair (65%) and yellow dots (65%) were the most common findings among all types of alopecia. the most common findings on trichoscopy in androgenetic alopecia were vellus hair (90.48%); in alopecia areata, vellus hair, and exclamation mark hair (86.67% each); in tinea capitis, corkscrew hair, and black dots; and in trichotillomania, splaying of hair. discoid lupus erythematosus had absent follicular opening, scaling, and perifollicular pigmentation. clinical and dermoscopic diagnoses were significantly associated with a kappa agreement of 0.776 (i.e., substantial agreement). out of 15 cases of difficult-to-diagnose alopecia, further investigations showed that dermoscopic diagnosis was accurate in 7 cases (46.67%). conclusions: trichoscopy is a reliable, non-invasive, and faster method of diagnosis in ambiguous cases of alopecia.