Objective: The aim of this study is to investigate the usefulness of dermoscopic findings in the clinical evaluation of beard alopecia areata (BAA). Materials and Methods: A total of 38 patients who presented with BAA diagnosed via clinical evaluation and 38 adults who did not have BAA (control group) were included. Their age, skin phototype, localization, severity, scalp involvement, duration of the disease, laboratory findings, and concomitant disorders were noted. Clinical and dermoscopic photos were taken by videodermoscope and recorded. Dermoscopic findings were analyzed according to the checklist described in previous articles for scalp alopecia. Results: Clinical severity of alopecia areata was observed as 13 (34.2%) solitary lesions, 22 (57.9%) multiple lesions, and 3 (11.1%) cases of total beard loss. According to the follicular features, white vellus and tapering hairs were detected 26 (68.4%) and 8 (21.1%) in the patient group, respectively. The difference between white vellus (p=0.001) and tapering hairs (p=0.003) was significant between the patient and the control groups. Other follicular findings, such as yellow dots, black dots, black vellus hairs, broken hairs, hair diameter diversity, and gray–white dots, did not show a significant difference between the patient and control groups. None of the interfollicular findings were significantly different between the two groups. Conclusion: According to our study, a dermoscopic evaluation is useful in the clinical evaluation of BAA. Detection of the white vellus and tapering hairs may guide diagnosing of BAA.
1. Rajabi F, Drake LA, Senna MM, Rezaei N. Alopecia areata: a review of disease pathogenesis. Br J Dermatol 2018; 179(5): 1033–48.
2. Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, et al. Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol 2018; 78(1): 1–12.
3. Saceda-Corralo D, Grimalt R, Fernandez-Crehuet P, Clemente A, Bernardez C, Garcia-Hernandez MJ, et al. Beard alopecia areata: a multicentre review of 55 patients. J Eur Acad Dermatol Venereol 2017; 31(1): 187–92.
4. Cervantes J, Fertig RM, Maddy A, Tosti A. Alopecia Areata of the Beard: A Review of the Literature. Am J Clin Dermatol 2017; 18(6): 789–96.
5. Karadağ Köse Ö, Güleç AT. Clinical evaluation of alopecias using a handheld dermatoscope. J Am Acad Dermatol 2012; 67(2): 206–14.
6. Inui S, Nakajima T, Itami S. Dry dermoscopy in clinical treatment of alopecia areata. J Dermatol 2007; 34(9): 635–9.
7. Inui S, Nakajima T, Nakagawa K, Itami S. Clinical significance of dermoscopy in alopecia areata: analysis of 300 cases. Int J Dermatol 2008; 47(7): 688–93.
8. Waskiel-Burnat A, Rakowska A, Kurzeja M, Czuwara J, Sikora M, Olszewska M, et al. The value of dermoscopy in diagnosisng eyebrow loss in patients with alopecia areata and frontal fibrosing alopecia. J Eur Acad Dermatol Venereol 2019; 33(1): 213–9.
9. Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol 2010; 62(2): 177–88, quiz 189–90.
10. Kavak A, Yesildal N, Parlak AH, Gokdemir G, Aydogan I, Anul H, et al. Alopecia areata in Turkey: demographic and clinical features. J Eur Acad Dermatol Venereol 2008; 22(8): 977–81.
11. Ranawaka RR. An observational study of alopecia areata in Sri Lankan adult patients. Ceylon Med J 2014; 59(4): 128–31.
12. Campuzano-Maya G. Cure of alopecia areata after eradication of Helicobacter pylori: a new association? World J Gastroenterol 2011; 17(26): 3165–70.
13. Emre S, Metin A, Caykoylu A, Akoglu G, Ceylan GG, Oztekin A, et al. Clinical characteristics and HLA alleles of a family with simultaneously occurring alopecia areata. Cutis 2016; 97(6): E30–E36.
14. Fernandez-Guarino M, Harto A, Garcia-Morales I, Perez-Garcia B, Arrazola JM, Jaen P. Failure to treat alopecia areata with photodynamic therapy. Clin Exp Dermatol 2008; 33(5): 585–7.
15. Khodaee M. Bald patch in the beard. Am Fam Physician 2014; 89(7): 583–4.
16. Richmond HM, Lozano A, Jones D, Duvic M. Primary cutaneous follicle center lymphoma associated with alopecia areata. Clin Lymphoma Myeloma 2008; 8(2): 121–4.
17. Sredoja Tišma V, Bulimbašić S, Jaganjac M, Stjepandić M, Larma M. Progressive pigmented purpuric dermatitis and alopecia areata as unusual skin manifestations in recognizing hereditary hemochromatosis. Acta Dermatovenerol Croat 2012; 20(3): 181–6.
18. Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, et al. Alopecia areata: an apprasial of new treatment approaches and overview of current therapies. J Am Acad Dermatol 2018; 78(1): 15–24.
19. Karadağ Köse Ö, Güleç AT. Alopesi areatalı hastalarda el dermoskopu kullanarak tedaviye yanıtın değerlendirilmesi. Turk J Dermatol 2018; 12(3): 143–8.
20. Ross EK, Vincenzi C, Tosti A. Videodermoscopy in the evaluation of hair and scalp disorders. J Am Acad Dermatol 2006; 55(5): 799–806.
21. Asz-Sigall D, Ortega-Springall MF, Smith-Pliego M, et al. White hair in alopecia areata: Clinical forms and proposed physiopathological mechanisms. J Am Acad Dermatol. 2019 Jan 7. doi: 10.1016/j. jaad.2018.12.047. [Epub ahead of print].
22. Inui S, Nakajima T, Itami S. Scalp dermoscopy of androgenetic alopecia in Asian people. J Dermatol 2009; 36(2): 82–5.
23. Karadağ Köse Ö, Borlu M. Definition of videodermoscopic features of demodicosis. Int J Dermatol 2019; 58(10): 1153–9.
24. Cutrone M, Grimalt R. The dermoscopic ‘Pluck out sign’ for beard trichotillomania. Skin Appendage Disord 2018; 4(1): 15–7.