Significance of Dermoscopy in Acute Diffuse and Total Alopecia of the Female Scalp: Review of Twenty Cases

Background: Acute diffuse and total alopecia of the female scalp (ADTAFS) is a new subtype of alopecia areata that is characterized by rapid progression of diffuse alopecia of the female scalp, marked female predominance and a favorable prognosis. Differential diagnosis of other types of diffuse alopecia such as female pattern hair loss (FPHL) is necessary in some cases. Objective: To describe dermoscopic findings of ADTAFS and to investigate the possibility of utilizing dermoscopy as a diagnostic tool for ADTAFS. Methods: Twenty cases of ADTAFS diagnosed by clinical and/or histological findings were examined by dermoscopy. Results: Cadaverized hairs ( black dots), exclamation mark hairs ( tapering hairs), broken hairs or yellow dots were seen in 18, 13, 19 and 17 out of 20 cases, respectively. One of these signs was seen in all cases (20/20). On the other hand, none of 12 cases with exclusively FPHL showed the dermoscopic features such as cadaverized hairs, exclamation mark hairs or broken hairs. Only 1 FPHL patient showed a yellow dot in the hair loss area. Conclusion: Dermoscopy is a helpful diagnostic tool for ADTAFS, especially to distinguish it from FPHL. Copyright (c) 2008 S. Karger AG, Basel