Trichoscopy
Encyclopedia
Trichoscopy is a method of hair and scalp evaluation and is used for diagnosing hair and scalp diseases. The method is based on dermoscopy and videodermoscopy. In trichoscopy hair and scalp structures may be visualized at many-fold magnification. Currently magnifications ranging from 10-fold to 70-fold are most popular in research and clinical practice.
The method was developed by groups of dermatologists directed by: Lidia Rudnicka
Lidia Rudnicka
Professor Lidia Rudnicka, MD, PhD is a Polish-American researcher and dermatologist with significant contributions to the field of scleroderma research, knowledge about hair diseases and work on challenges of melanoma prevention.Lidia Rudnicka is currently chairman of Department of Dermatology...

 in Poland, Antonella Tosti
Antonella Tosti
Antonella Tosti is an Italian physician and scientist with major contributions in the field of dermatology.She is the author of Dermoscopy of Hair and Scalp Disorders, the first hair and scalp dermoscopy atlas ever published....

 and Giuseppe Micali in Italy and Shigeki Inui in Japan. In 2004 Francesco Lacarrubba and coworkers first described videodermoscopic features of alopecia areata
Alopecia areata
Alopecia areata is a medical condition in which hair is lost from some or all areas of the body, usually from the scalp. Because it causes bald spots on the scalp, especially in the first stages, it is sometimes called spot baldness. In 1–2% of cases, the condition can spread to the entire scalp ...

 (micro-exclamation hairs, yellow hyperkeratotic hair follicle openings, and black cadaverized hairs. In 2005 Malgorzata Olszewska and Lidia Rudnicka first used videodermoscopy for evaluation of disease severity in androgenic alopecia and for monitoring treatment efficacy. Characteristic images of female androgenic alopecia included hair shaft heterogeneity and increased percentage of thin (below 30 micrometers) hairs at the vertex. The Polish group than developed criteria to diagnose female androgenic alopecia based solely on videodermoscopy images. In 2006 Elizabeth K Ross and coworkers specified videodermoscopy features of different acquired hair and scalp diseases. In 2008 Rakowska and coworkers first showed usefulness of trichoscopy in diagnosing children with congenital hair shaft abnormalities. It was shown that this method is especially helpful in diagnosing monilethrix
Monilethrix
Monilethrix is a rare autosomal dominant hair disease that results in short, fragile, broken hair that appears beaded. It comes from the Latin word for necklace and the Greek word for hair ....

, Netherton syndrome
Netherton syndrome
Netherton syndrome is a severe, autosomal recessive form of ichthyosis associated with mutations in the SPINK5 gene. It is named after E.W. Netherton.- Characteristics :...

 and other pediatric diseases. In 2008 the first atlas containing trichoscopy images was published by Antonella Tosti.

The term "trichoscopy" was first suggested in 2006 by Lidia Rudnicka and Malgorzata Olszewska.

In 2011 S.Inui published a trichoscopy algorithm, which allows differential diagnosis of most common hair and scalp diseases (including alopecia areata
Alopecia areata
Alopecia areata is a medical condition in which hair is lost from some or all areas of the body, usually from the scalp. Because it causes bald spots on the scalp, especially in the first stages, it is sometimes called spot baldness. In 1–2% of cases, the condition can spread to the entire scalp ...

, androgenic alopecia, telogen effluvium
Telogen effluvium
Telogen effluvium is a scalp disorder characterized by thinning/shedding of hair resulting from the early entry of hairs into the telogen phase.Emotional or physiological stressful events may result in an alteration of the normal hair cycle....

 and cicatricial alopecia
Cicatricial alopecia
The term cicatricial alopecia refers to a diverse group of rare disorders that destroy the hair follicle, replace it with scar tissue, and cause permanent hair loss. A variety of distributions are possible. In some cases, hair loss is gradual, without symptoms, and is unnoticed for long periods...

) based on trichoscopy.

Further reading

  • Tosti A. Atlas: Dermoscopy of Hair and Scalp Disorders: Pathological and Clinical Correlations. Informa Healthcare; 2008
  • Olszewska M, Rudnicka L. "A novel method for diagnosing and monitoring androgenic alopecia" in
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