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An Exploratory Miniaturization Burden Index in Female Androgenetic Alopecia: A Digital Trichoscopy Case-Control Study
Artina Pajaziti1, Besa Gacaferi-Lumezi2, Burim Neziri3
1Dermatovenerology Department, University Clinical Center of Kosovo, Prishtina, Kosovo.
Introduction:
Female androgenetic alopecia (AGA) is characterized by progressive follicular miniaturization, which can be objectively assessed using digital trichoscopy. Although individual trichoscopic markers are well established, a simple composite measure may help summarize the overall miniaturization burden in clinical and research settings.
Methods:
This single-center, cross-sectional case-control study included 72 women with AGA and 87 healthy female controls. Standardized digital trichoscopy was performed in frontal, temporal, and occipital scalp regions. The Miniaturization Burden Index (MBI) was calculated as thin hairs (%) + single follicular units (%) - thick hairs (%), and Global_MBI as the mean regional value. AGA severity was graded using the Ludwig classification.
Results:
Groups were comparable in age. Women with AGA had significantly higher regional and Global_MBI values than controls. The greatest difference was observed in the frontal region. Global_MBI was also significantly higher in AGA than in controls. Within the AGA group, Global_MBI showed a significant positive correlation with Ludwig clinical severity.
Conclusion:
The MBI may provide a simple exploratory composite measure of trichoscopic miniaturization burden in female AGA. Further studies are needed to validate its diagnostic performance, reproducibility, and longitudinal utility.
