Letter

Pinpoint white dots in the scalp: Dermoscopic and histopathologic correlation

Androgenetic alopecia (AGA) is the most common form of alopecia in men, affecting 70% by the age of 20 years. The present study was conducted with the objective of comparing the efficacy of monotherapy with topical 5% minoxidil and its combination with intradermal platelet rich plasma (PRP), in male AGA.

This observational study was conducted at the dermatology department of a tertiary care hospital over a duration of 2 years. 100 patients with AGA were selected and divided randomly into 2 treatment arms: Group A (MM): received topical 5% Minoxidil monotherapy for 12 months and; Group B (M + PRP): received combination therapy of PRP and topical 5% Minoxidil for 12 months. The following parameters were subsequently analyzed on follow up: Physician-assessed global photography by a 4-point improvement scale and trichoscopic improvement of mean hair diameter.

The combination was statistically superior to the monotherapy group in promoting hair growth in men with AGA for both measures of hair growth – photographic assessment and trichoscopic mean diameter.

We hereby conclude that intradermal PRP injections should be offered to all patients with AGA along with the existing therapeutic modalities, for faster hair regrowth and improved compliance.

Rosettes are small white structures visible with polarized light dermoscopy, whose exact morphological correlation is not yet defined. These small shiny structures are found in several conditions such as scarring, dermatofibroma, molluscum contagiosum, squamous cell carcinoma, basal cell carcinoma, melanoma, melanocytic nevus, discoid lupus erythematosus, and papulopustular rosacea. In this novel report, the authors describe the presence of rosettes in a T-cell pseudolymphoma lesion.

Dermatoscopy has been widely used in dermatology for the evaluation of pigmented skin lesions. More recently, dermatoscopy has been used in the evaluation of hair and scalp disorders, allowing visualization of morphologic structures not readily visible to the naked eye, including changes to hair shaft thickness and shape, as well as perifollicular and interfollicular features. When used for such purposes, hair and scalp dermatoscopy is also known as trichoscopy. In this chapter, we discuss the technique itself, the various uses of trichoscopy, and the main trichoscopic structures.

Trichoscopy refers to dermoscopy of the hair and scalp. A dermoscope in reality is the old magnifying lens gone hi-tech; thus it can be referred to as a digital magnifier. Trichoscopic criteria and diagnostic findings in common hair and scalp conditions have been described in this chapter to further simplify the process. We have highlighted the diagnostic features of noncicatricial and cicatricial alopecias, genetic hair shaft disorders, psoriasis, and seborrheic dermatitis. The images and findings are predominantly from the Indian skin subtypes, and we have also compiled data from across the world and from different population types to bring out the variations seen. The efforts are aimed not only toward sensitizing the practicing dermatologists and students toward the multiple applications of a dermoscope but also to obviate the need of invasive procedures for disease confirmation.

This paper reviews the recent literature on the diseases of the hair and pilosebaceous unit that may cause a red face. We discuss the epidemiology, clinicals, pathogenesis, and therapy of lichen planopilaris with its variants, discoid lupus erythematosus, folliculitis decalvans, dissecting folliculitis, acne keloidalis nuchae, pseudofolliculitis barbae, tinea capitis, tinea barbae, folliculitis of diverse causative factors and inflammatory follicular keratotic syndromes, ulerythema ophryogenes, atrophoderma vermiculatum, keratosis follicularis spinulosa decalvans, and folliculitis spinulosa decalvans.