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Mani S, Raut A, Neema S, Khandare M, Golas P, Sandhu S, Kothari R, Rajput GR, Oberoi B. Trichoscopy in Alopecia Areata and Trichotillomania in Skin of Colour: A Comparative Study. Indian J Dermatol 2023; 68:78-84. [PMID: 37151271 PMCID: PMC10162753 DOI: 10.4103/ijd.ijd_587_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
Alopecia areata (AA) and trichotillomania (TTM) are the two common causes of localised non scarring alopecia. While AA is an autoimmune disorder, TTM is an impulse control disorder which makes the treatment of the two entities completely different. Trichoscopy is a non-invasive tool used to diagnose hair disorders, which not only is extremely helpful in diagnosing AA and TTM but also differentiates them from other hair disorders as well. The aim of our study is to describe the various trichoscopic features of AA and TTM and to compare the frequency of each trichoscopic feature in order to establish diagnostic clues for differentiating AA and TTM. Trichoscopy was performed on clinically diagnosed cases of AA and TTM with DL4 dermoscope and the images were analysed by 2 dermatologists independently. The frequency of trichoscopic features in AA and TTM was compared using chi square test. Twenty-four patients of TTM and 50 patients of AA were included in the study with mean age of AA being 30 years and mean age of TTM being 23.4 years. Exclamation mark hair, tapered hair, coudability hair, pigtail hair, clustered vellous hair, clustered regrowing hair and white hair were significantly more in alopecia areata. Conversely broken hair of different length, trichoptilosis, flame hair, mace hair, coiled hair, hair powder, fractured hair, v sign and burnt matchstick sign were the common features in TTM. To conclude, even though there is an overlap of trichoscopic features in AA and TTM, it is possible to distinguish the two if an assemblage of specific features are present.
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Affiliation(s)
- Siddharth Mani
- From the Department of Dermatology, INHS Sanjivani, Kochi, Kerala, India
| | - Aradhana Raut
- From the Department of Dermatology, INHS Sanjivani, Kochi, Kerala, India
| | - Shekhar Neema
- From the Department of Dermatology, INHS Sanjivani, Kochi, Kerala, India
| | - Manish Khandare
- From the Department of Dermatology, INHS Sanjivani, Kochi, Kerala, India
| | - Prateksha Golas
- From the Department of Dermatology, INHS Sanjivani, Kochi, Kerala, India
| | - Sunmeet Sandhu
- From the Department of Dermatology, INHS Sanjivani, Kochi, Kerala, India
| | - Rohit Kothari
- From the Department of Dermatology, INHS Sanjivani, Kochi, Kerala, India
| | | | - Bhavni Oberoi
- From the Department of Dermatology, INHS Sanjivani, Kochi, Kerala, India
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Rossi A, Muscianese M, Piraccini BM, Starace M, Carlesimo M, Mandel VD, Alessandrini A, Calvieri S, Caro G, D'arino A, Federico A, Magri F, Pigliacelli F, Amendolagine G, Annunziata MC, Arisi MC, Astorino S, Babino G, Bardazzi F, Barruscotti S, Belloni Fortina A, Borghi A, Bruni F, Caccavale S, Calzavara-Pinton P, Cameli N, Cardone M, Carugno A, Coppola R, Dattola A, De Felici Del Giudice MB, Di Cesare A, Dika E, Di Nunno D, D'ovidio R, Fabbrocini G, Feliciani C, Fulgione E, Galluzzo M, Garcovich S, Garelli V, Guerriero C, Hansel K, La Placa M, Lacarrubba F, Lora V, Marinello E, Megna M, Micali G, Misciali C, Monari P, Monfrecola G, Neri I, Offidani A, Orlando G, Papini M, Patrizi A, Piaserico S, Rivetti N, Simonetti O, Stan TR, Stingeni L, Talamonti M, Tassone F, Villa L, Vincenzi C, Fortuna MC. Italian Guidelines in diagnosis and treatment of alopecia areata. GIORN ITAL DERMAT V 2019; 154:609-623. [PMID: 31578836 DOI: 10.23736/s0392-0488.19.06458-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The Italian Study Group for Cutaneous Annexial Disease of the Italian Society of dermatology proposes these Italian guidelines for diagnosis and treatment of Alopecia Areata deeming useful for the daily management of the disease. This article summarizes evidence-based treatment associated with expert-based recommendations.
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Affiliation(s)
- Alfredo Rossi
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy -
| | - Marta Muscianese
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Bianca M Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Marta Carlesimo
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Victor D Mandel
- Unit of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Aurora Alessandrini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Calvieri
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Gemma Caro
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Andrea D'arino
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Alessandro Federico
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Francesca Magri
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Flavia Pigliacelli
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Graziana Amendolagine
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria C Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Maria C Arisi
- Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Stefano Astorino
- Unit of Dermatology and Venereology, Celio Military Hospital, Rome, Italy
| | - Graziella Babino
- Unit of Dermatology, Nuovo Policlinico, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Federico Bardazzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefania Barruscotti
- Unit of Dermatology, S. Matteo University Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Anna Belloni Fortina
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Alessandro Borghi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Francesca Bruni
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Caccavale
- Unit of Dermatology, Nuovo Policlinico, Luigi Vanvitelli University of Campania, Naples, Italy
| | | | - Norma Cameli
- San Gallicano Dermatological Institute (IRCCS), Rome, Italy
| | - Michele Cardone
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Andrea Carugno
- Unit of Dermatology, S. Matteo University Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Rosa Coppola
- Campus Bio-Medico University (Hospital), Rome, Italy
| | - Annunziata Dattola
- Department of Dermatology, Tor Vergata Polyclinic and University, Rome, Italy
| | | | - Antonella Di Cesare
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Emi Dika
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Donato Di Nunno
- Unit of Dermatology and Venereology, Celio Military Hospital, Rome, Italy
| | | | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Claudio Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Elisabetta Fulgione
- Unit of Dermatology, Nuovo Policlinico, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Marco Galluzzo
- Department of Dermatology, Tor Vergata Polyclinic and University, Rome, Italy
| | - Simone Garcovich
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | - Valentina Garelli
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Cristina Guerriero
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Michelangelo La Placa
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | - Viviana Lora
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | - Elena Marinello
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giuseppe Micali
- Department of Dermatology, University of Catania, Catania, Italy
| | - Cosimo Misciali
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Paola Monari
- Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Giuseppe Monfrecola
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annamaria Offidani
- Unit of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Gloria Orlando
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Manuela Papini
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Piaserico
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Niccolò Rivetti
- Unit of Dermatology, S. Matteo University Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Oriana Simonetti
- Unit of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Teodora R Stan
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Marina Talamonti
- Department of Dermatology, Tor Vergata Polyclinic and University, Rome, Italy
| | - Francesco Tassone
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | | | - Colombina Vincenzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Maria C Fortuna
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
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