Alopecia areata Lidia Rudnicka Department of Dermatology, Medical - - PowerPoint PPT Presentation

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Apr 07, 2024 211 likes •488 views

Alopecia areata Lidia Rudnicka Department of Dermatology, Medical University of Warsaw Poland lidiarudnicka@gmail.com I have no relevant conflicts of interest anagen phase Hair cycle telogen phase catagen phase anagen effluvium Anagen

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Alopecia areata

Lidia Rudnicka

Department of Dermatology, Medical University of Warsaw Poland

I have no relevant conflicts of interest lidiarudnicka@gmail.com

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Hair cycle

anagen phase catagen phase telogen phase

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Anagen effluvium occurs after any insult to the hair follicle that impairs its mitotic activity. anagen effluvium Causes: Inflammatory (alopecia areata) Drug-induced (chemotherapy, retinoids) Toxic (thallium, arsenic) Extreme nutrient deficiencies

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High mitotic activity - thick hair Low mitotic activity - thin hair No mitotic activity - no hair

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Rare trichoscopy features of AA
Trichoscopic cases in AA
Common trichoscopy features of AA

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Exclamation mark hairs Black dots Yellow dots

Alopecia areata in trichoscopy

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Multiple exclamation mark hairs = high disease activity

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Inui et al. 2009

Alopecia areata – tapered hairs

Tapered hairs are elongated exclamation mark hairs

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Pohl-Pinkus constrictions and monilethrix-like hairs in alopecia areata

These hairs differ from true monilethrix by the irregular distribution

f constrictions

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Alopecia areata – black dots

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black dots a marker of high disease activity in alopecia areata but not specific for alopecia areata

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Alopecia areata – yellow dots

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S. Inui . Trichoscopy in Asian Skin in Atlas of Trichoscopy, 2012

Yellow dots may not be visible in Asian patients

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Rare trichoscopy features of AA
Trichoscopic cases in AA
Common trichoscopy features of AA

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Alopecia areata – vellus hairs

Caucasian Asian

Marker of disease severity ?

Inui et al

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Trichorrhexis nodosa
Zigzag hairs

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Zigzag hairs

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Alopecia areata – regrowing hairs

circle pigtail

70x

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Trichoscopy feature % of patients with AA

Yellow dots 63-94% Black dots 44-70% Exclamation mark hairs 30-44% Tapered hairs 12-42% Broken hairs 45-58% Vellus hairs 33-72% Trichorrhexis nodosa 3-16% Monilethrix-like hairs 2-3% Pohl-Pinkus constrictions Regrowing hairs

Source: Atlas of Trichoscopy, 2012

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Rare trichoscopy features of AA
Trichoscopic cases in AA
Common trichoscopy features of AA

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43 – year old woman Chemotherapy – induced alopecia

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