Article

Reflectance confocal microscopy of the yellow dot pattern in alopecia areata.

San Gallicano Dermatologic Institute, IRCCS, Rome, Italy.
Archives of dermatology (impact factor: 4.76). 01/2011; 147(1):61-4. DOI:10.1001/archdermatol.2010.288
Source: PubMed

ABSTRACT The presence of yellow dots is a characteristic dermoscopic finding in alopecia areata. The aim of this study was to investigate the yellow dot pattern observed at dermoscopy in alopecia areata with reflectance confocal microscopy (RCM) and correlate RCM findings with pathological features.
Six patients affected by alopecia totalis entered the study. Patients were first submitted to scalp dermoscopy, which was followed by RCM examination of the same area. After RCM, a 5-mm punch biopsy specimen was also taken. Dermoscopic findings showed the yellow dot pattern in all patients, with round or polycyclic yellow-pink dots often containing miniaturized or broken hair shafts. At RCM, a Vivablock mosaic taken at the level of the spinous layer showed striking reduction of follicular adnexal structures and empty lumina containing highly refractile material corresponding to the yellow dots seen on dermoscopy. The pathological features showed that the yellow dots correspond to the dilated infundibula of the velluslike anagen and telogen follicles that characterize the chronic phase of alopecia areata.
The RCM study of the yellow dot pattern showed a good correlation with the dermoscopic and pathological findings and confirms that the yellow dots correspond to inefficient follicular structures that often contain hair remnants.

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    Article: Alopecia: evaluation and treatment.
    Katherine A Gordon, Antonella Tosti
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    ABSTRACT: Hair loss is a very common complaint. Patients may describe increased shedding and diffuse or localized alopecia. The differential diagnosis of hair loss includes a number of disorders causing cicatricial or noncicatricial alopecias. This paper describes the clinical approaches and diagnostic tests that are useful in the evaluation of patients presenting with alopecia. It also reviews treatments for noncicatricial alopecias, including androgenetic alopecia, alopecia areata, and telogen effluvium, as well as cicatricial alopecias, including lichen planopilaris, its clinical variant frontal fibrosing alopecia, and discoid lupus erythematosus.
    Clinical, Cosmetic and Investigational Dermatology 01/2011; 4:101-6.
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Keywords

5-mm punch biopsy specimen
 
alopecia areata
 
alopecia totalis
 
contain hair remnants
 
correlate RCM findings
 
Dermoscopic findings
 
follicular adnexal structures
 
inefficient follicular structures
 
pathological findings
 
polycyclic yellow-pink dots
 
RCM examination
 
RCM study
 
reflectance confocal microscopy
 
refractile material corresponding
 
spinous layer
 
telogen follicles
 
velluslike anagen
 
yellow dot pattern
 
yellow dots
 
yellow dots correspond