Relevance of Trichoscopy in Differential Diagnosis of Focal Non-cicatricial Alopecia in Children

The majority of alopecia in children is presented as patchy alopecia, which is most commonly diagnosed as alopecia areata. However, other causes of patchy alopecia such as tinea capitis, trichotillomania, temporal triangular alopecia (TTA), nevus sebaceous and aplasia cutis congenita (ACC) can be easily missed.

Trichoscopy (hair and scalp dermoscopy) is a non-invasive diagnostic tool that allows the recognition of morphologic structures not visible by the naked eye.

Trichoscopy allows visualization of hair shafts at high magnification and performing measurements, such as hair shaft thickness, without the need of removing hair for diagnostic purposes. It also allows in vivo visualization of the epidermal portion of hair follicles and perifollicular epidermis.

The advantages of trichoscopy in evaluating hair loss in children are numerous, as it is a fast in-office technique , non-invasive, inexpensive, and painless , and therefore it will be accepted by children and their parents.

Tinea capitis and alopecia areata are considered to be the most common causes of hairless patches of the scalp in pediatrics. Tinea capitis especially non-scaly type may have the same clinical appearance of alopecia areata, so trichoscopy has recently become a useful diagnostic tool for alopecia areata and tinea capitis, especially in doubtful cases as lab investigations like fungal culture or biopsy may take several weeks.

Inclusion criteria

-age from 3-18 years of both sexes with focal non-cicatricial alopecia.(1-5 patches of alopecia)

Exclusion criteria

• Patients who will not consent.
• uncooperative children.
• patients with active secondary bacterial infection in the alopecic patch.
• patients with any concomitant dermatological diseases.
• history of using any topical(1 month) or systemic treatment (3 month) for tinea capitis or alopecia areata prior to the study,
• cicatricial alopecia.