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Diagnostic Accuracy of Trichoscopy in Inflammatory Scalp Diseases: A Systematic Review
Joanna Golińska1, Marta Sar-Pomian2, Lidia Rudnicka2
1Department of Dermatology, Medical University of Warsaw, Warsaw, Poland, golinskajoanna5@gmail.com.
Background:
The common inflammatory scalp diseases, such as psoriasis, seborrheic dermatitis, lichen planopilaris, discoid lupus erythematosus, contact dermatitis, or pemphigus may share similar clinical features.
Objective:
To identify and systematically review the available evidence on the accuracy of trichoscopy in inflammatory scalp disorders.
Methods:
A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 58 articles were included in the analysis.
Results:
The following trichoscopy features were found to show the highest specificity for the respective diseases: in psoriasis: diffuse scaling, simple and twisted red loops, red dots and globules, and glomerular vessels; in seborrheic dermatitis: atypical vessels, thin arborizing vessels, and structureless red areas; in discoid lupus erythematosus: follicular plugs and erythema encircling follicles; in lichen planopilaris: milky red areas or fibrotic patches; in contact dermatitis: twisted red loops; in pemphigus foliaceus: white polygonal structures and serpentine vessels; in pemphigus vulgaris: red dots with whitish halo and lace-like vessels; and in dermatomyositis: lake-like vascular structures.
Limitations:
Different nomenclature and variability in parameters, which were analyzed in different studies.
Conclusion:
This systemic analysis indicates that trichoscopy may be used with high accuracy in the differential diagnosis of inflammatory scalp diseases.
