El papel de la tricoscopia en el diagnóstico y seguimiento de las alopecias cicatriciales

Hair and scalp dermoscopy, also called trichoscopy, is an in-office technique that may be performed with a handheld dermoscope or a digital videodermoscope with a 10x to 70x magnification images. This method of evaluation for alopecia is now gaining importance for diagnosis and follow-up of patients. Cicatricial alopecia is less frequent in clinical practice comparing to noncicatricial alopecia, and are commonly divided in lymphocytic, neutrophilic or mixed, according to the inflammatory cells observed. Regardless the low frequency, they offer a vast number of dermoscopic structures divided into four groups: 1) hair shafts, 2) hair follicle openings, 3) perifollicular epidermis, and 4) blood vessels. The most common structures in cicatricial alopecia are the loss of orifices, milky red areas, thick arborizing vessels, perifollicular scales, perifollicular hyperplasia with starburst pattern and 3D dots appearance. Trichoscopy is also useful in guided scalp biopsy in cicatricial alopecia and in therapeutic follow-up.