Trichoscopy pattern and evaluation of serum vitamin D status in alopecia areata

Photodiagnosis Photodyn Ther. 2023 Jun:42:103510. doi: 10.1016/j.pdpdt.2023.103510. Epub 2023 Mar 20.

Abstract

Background: Vitamin D (VD) insufficiency has been linked to a number of autoimmune illnesses including, alopecia areata (AA). To distinguish between clinically common hair problems, trichoscopy is a beneficial non-invasive, rapid, and affordable procedure that is yet neglected.

Objective: to evaluate trichoscopic patterns and severity in various clinical categories of AA considering vitamin D level (VDL). Also, focusing on specific patterns of trichoscopy in AA related to VDL.

Subject and methods: Severity of Alopecia Tool (SALT) was used to clinically assess patients with AA scores. Trichoscopic patterns were analyzed concerning VDL and disease severity. The VDL was estimated for 59 patients and 60 healthy controls.

Results: VDL was higher in healthy controls than in AA patients. The most common trichoscopic findings seen in our study were yellow dots (77.97%), followed by black dots (67.8%), and broken hairs (59.32%). Short vellus hairs and yellow dots were the most common in remitting AA. In progressive AA, the most common findings were broken hairs, yellow dots, and tapering hairs. VDL was significantly higher in both mild and moderate AA.

Conclusions: VDL was significantly lower in severe AA and active progressive disease. Trichoscopic features could predict disease activity and VDL in patients with AA. Broken and tapering hairs will be more represented in patients with progressive disease. Short vellus hairs were seen more in stable or remitting disease. Furthermore, black dots and broken hairs were more prevalent in AA with deficient VDL.

Keywords: Alopecia areata; Dermatoscopy; Trichoscopy; Videodermoscopy; Vitamin D.

MeSH terms

  • Alopecia Areata* / diagnostic imaging
  • Dermoscopy / methods
  • Humans
  • Photochemotherapy* / methods
  • Photosensitizing Agents
  • Vitamin D

Substances

  • Vitamin D
  • Photosensitizing Agents

Supplementary concepts

  • Diffuse alopecia