The trichogram as a prognostic tool in alopecia areata

The value of the trichogram as a prognostic tool in alopecia areata was investigated in 93 patients with not more than three lesions on the scalp. Evaluation of the clinical features was one year later. In each patient, two regions were investigated: the margin of one of the lesions and the control region. In 80% of the patients with a normal trichogram at the margin of the lesional hair at the first visit, hair growth was restored one year later, whereas in those with an abnormal trichogram, hair growth was restored in 62.5%. In 11.5% of the patients an alopecia totalis or universalis developed. At the margin of the lesion, no significant association was observed between the trichogram and the clinical features. In the control region, however, the prognosis was much better (p < 0.001) in patients with a normal trichogram than in those with an abnormal trichogram. Out of the 62 patients with a normal trichogram, hair growth was restored in 53 (85%), whereas out of the 31 patients with an abnormal trichogram hair growth was restored in only 6 (19%). These findings indicate that a normal trichogram in the control region is a valuable prognostic tool in alopecia areata.