Trichoscopic Differentiation in Alopecia: Retrospective Case Series Comparing Lichen Planopilaris, Discoid Lupus Erythematosus, and Alopecia Areata

This retrospective case series involving 28 patients (7 with lichen planopilaris, 7 with discoid lupus erythematosus, and 14 with alopecia areata) identified key trichoscopic markers to differentiate between nonscarring and scarring alopecias. Exclamation-mark hairs and yellow dots were characteristic of alopecia areata, while white scarring and follicular ostia loss were exclusive to lichen planopilaris and discoid lupus erythematosus. These findings suggest a practical approach for clinicians to distinguish between these conditions, aiding in biopsy site selection and treatment planning. The study highlights the need for larger multicenter studies to validate these findings and refine diagnostic criteria.