Abstract
Clinical management of alopecia represents one of the major issues in dermatology. Scalp biopsies are not easily accepted because of the high bleeding and sensitive anatomical area. Trichoscopy is routinely used for diagnosis of alopecia, but in several cases lack to provide sufficient information on the status of the disease. Recently, reflectance confocal microscopy demonstrated its usefulness for the evaluation of several inflammatory skin condition and preliminary reports about alopecia have been proposed in the literature. The aim was to identify the confocal features characterizing scarring and non-scarring alopecia. Reflectance confocal microscopy from 86 patients affected by scarring (28 lichen planopilaris and 9 lupus erythematosus) and non-scarring alopecia (30 androgenic alopecia and 19 alopecia areata), were retrospectively, blinded evaluated. Good concordance between different readers on the confocal criteria has been assessed. Statistical significant features, specific for scarring alopecia and non-scarring alopecia have been identified. In this study, data on reflectance confocal microscopy features useful for the differential diagnosis between scarring and non-scarring alopecia have been identified. Further studies focusing on the use of this non-invasive technique in the therapeutic follow-up and distinction of sub-entities of alopecia are still required.
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Abbreviations
- RCM:
-
Reflectance confocal microscopy
- SA:
-
Scarring alopecia
- NSA:
-
Non-scarring alopecia
- AA:
-
Alopecia areata
- AGA:
-
Androgenic alopecia
- LPP:
-
Lichen planopilaris
- LE:
-
Lupus erythematosus
- DEJ:
-
Dermo-epidermal junction
- DP:
-
Dermal papillae
References
Agozzino M, Berardesca E, Donadio C, Franceschini C, de Felice CM, Cavallotti C, Sperduti I, Ardigò M (2014) Reflectance confocal microscopy features of seborrheic dermatitis for plaque psoriasis differentiation. Dermatology 229:215–221
Agozzino M, Donadio C, Franceschini C, Ardigò M (2015) Therapeutic follow-up of Lichen Planopilaris using in vivo reflectance confocal microscopy: a case report. Skin Res Technol 21:380–383
Agozzino M, Tosti A, Barbieri L, Moscarella E, Cota C, Berardesca E, Ardigò M (2011) Confocal microscopic features of scarring alopecia: preliminary report. Br J Dermatol 165:534–540
Ardigo M, Donadio C, Franceschini C, Catricalà C, Agozzino M (2015) Interest of reflectance confocal microscopy for inflammatory oral mucosal diseases. J Eur Acad Dermatol Venereol 29:1850–1853
Ardigò M, El Shabrawi-Caelen L, Tosti A (2014) In vivo reflectance confocal microscopy assessment of the therapeutic follow-up of cutaneous T-cell lymphomas causing scalp alopecia. Dermatol Ther 27:248–251
Ardigò M, Maliszewski I, Cota C, Scope A, Sacerdoti G, Gonzalez S, Berardesca E (2007) Preliminary evaluation of in vivo reflectance confocal microscopy features of discoid lupus erythematosus. Br J Dermatol 156:1196–1203
Ardigò M, Torres F, Abraham LS, Piñeiro-Maceira J, Cameli N, Berardesca E, Tosti A (2011) Reflectance confocal microscopy can differentiate dermoscopic white dots of the scalp between sweat gland ducts or follicular infundibulum. Br J Dermatol 164:1122–1124
Ardigò M, Tosti A, Cameli N, Vincenzi C, Misciali C, Berardesca E (2011) Reflectance confocal microscopy of the yellow dot pattern in alopecia areata. Arch Dermatol 147:61–64
Moghadam-Kia S, Franks AG Jr (2013) Autoimmune disease and hair loss. Dermatol Clin 31:75–91
Moscarella E, González S, Agozzino M, Sánchez-Mateos JL, Panetta C, Contaldo M, Ardigò M (2012) Pilot study on reflectance confocal microscopy imaging of lichen planus: a real-time, non-invasive aid for clinical diagnosis. J Eur Acad Dermatol Venereol 26:1258–1265
Mubki T, Rudnicka L, Olszewska M, Shapiro J (2014) Evaluation and diagnosis of the hair loss patient: part II. Trichoscopic and laboratory evaluations. J Am Acad Dermatol 71(3):431.e1–431.e11
Otberg N (2013) Primary cicatricial alopecias. Dermatol Clin 31:155–166
Panchaprateep R, Tanus A, Tosti A (2015) Clinical, dermoscopic, and histopathologic features of body hair disorders. J Am Acad Dermatol 72(5):890–900
Papadopoulos AJ, Schwartz RA, Janniger CK (2000) Alopecia areata. pathogenesis, diagnosis, and therapy. Am J Clin Dermatol 1:101–105
Ulrich M, Lange-Asschenfeldt S, Gonzalez S (2012) Clinical applicability of in vivo reflectance confocal microscopy in dermatology. G Ital Dermatol Venereol 147:171–178
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M. Ardigò and M. Agozzino equally contributed to this work.
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Ardigò, M., Agozzino, M., Franceschini, C. et al. Reflectance confocal microscopy for scarring and non-scarring alopecia real-time assessment. Arch Dermatol Res 308, 309–318 (2016). https://doi.org/10.1007/s00403-016-1657-4
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DOI: https://doi.org/10.1007/s00403-016-1657-4