Misdiagnoses of Hair and Scalp Disorders in Adult Patients With Skin of Color

July 2025 in “ International Journal of Dermatology ”

Eric McMullen, Marissa Joseph, Samantha Mannala, Dea Metko, Shanti Mehta, Kristie Mar, Nawar Tarafdar, Kyobin Hwang, Touraj Khosravi‐Hafshejani, Mahan Maazi, Jeffrey Donovan

hair and scalp disorders skin of color scalp biopsy trichoscopy

TLDR Misdiagnosis of hair and scalp disorders is common in patients with skin of color, highlighting the need for better training and evaluation.

The study investigates the misdiagnosis of hair and scalp disorders in patients with skin of color (SoC), highlighting the challenges faced due to low representation of SoC in medical education. A systematic review of 21 studies involving 30 patients, predominantly female and Black, revealed that 63% experienced misdiagnoses, with severe cases including life-threatening conditions like T-cell lymphoblastic lymphoma and leukemia. Scalp biopsies were more effective than trichoscopy in achieving correct diagnoses. The study emphasizes the need for thorough clinical evaluations and improved SoC-specific training in medical education to reduce diagnostic errors. Limitations include potential misclassification and lack of a comparison group, suggesting the need for further large-scale studies.

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Research cited in this study

2 / 2 results

research Scalp Biopsy Influences Diagnostic Accuracy and Treatment in Black Women With Alopecia: A Retrospective Study

2 citations , January 2023 in “Journal of The American Academy of Dermatology”

Scalp biopsies greatly improved diagnosis and treatment for Black women with unclear alopecia.

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Hair loss in people with darker skin has unique challenges and requires careful diagnosis and treatment.

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community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

nkrata in Research 830 upvotes 1 year ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

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in Microneedling 22 upvotes 2 years ago

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community 1.5 years topical minox 0.5 ml twice (just temples) + 0.5 mg oral finasteride daily.

in Progress Pictures 664 upvotes 5 months ago

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community I lost the fight against MPB at age 22 despite being on treatments.

in Finasteride/Dutasteride 72 upvotes 2 years ago

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community 137 years old and still far more hair than the average r/tressless user

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community 18m, already balding. Is a hair system the way to go? I don’t have the strength to go bald this young

in Hair Systems 148 upvotes 2 months ago

An 18-year-old with early hair loss is advised to consider minoxidil and finasteride, with a doctor's consultation recommended. Alternatives like a hair system or shaving are suggested due to potential medication side effects and lifelong commitment.

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