Trichoscopic clues of the scalp in moderate to severe atopic dermatitis: a monocentric analysis

Atopic dermatitis (AD) stands as the prevailing chronic relapsing inflammatory dermatosis within the general population. Scalp involvement is a minor but frequent feature of AD, nevertheless it was relatively understudied up to now. This research aims to better describe the clinical and trichoscopic aspects of scalp involvement in moderate-to-severe AD, focusing on the vascular pattern of the vessels and scalp desquamation.

A single-center retrospective and prospective study was conducted on 20 patients, collecting clinical and trichoscopic images at the Dermatology Unit of the University of Bologna, Italy.

Scalp lesions exhibited distinct morphological characteristics in both vascular and desquamation patterns. Three main trichoscopic patterns with a different grade of involvement were identified: erythematous pattern, erythematous desquamative pattern and exudative with crusts pattern. As for the limitations, the sample size was relatively small, and, being a single-centre study, the results may not be applicable to other populations or settings. In addition, no standardized criteria for trichoscopic analysis are available.

This is the first study with the purpose to delineate the trichoscopic characteristics observed in patients with moderate-to-severe AD not in systemic therapy, thereby highlighting three distinct patterns of trichoscopy manifestations that define three distinct populations.