Trichoscopic Features of Syphilitic Alopecia and Alopecia Areata: A Comparative Study

August 2023 in “ Clinical Cosmetic and Investigational Dermatology ”

Kasama Tejapira, Nawara Sakpuwadol, Cherrin Pomsoong, Yanisa Ratanapokasatit, Poonkiat Suchonwanit

trichoscopy syphilitic alopecia alopecia areata exclamation mark hairs

TLDR Exclamation mark hairs help distinguish syphilitic alopecia from alopecia areata.

This study compared trichoscopic features in 23 patients with syphilitic alopecia (SA) and 46 with alopecia areata (AA), finding that exclamation mark hairs, angulated hairs, and non-pigmented regrowing hairs were more prevalent in AA, while scalp abnormalities like erythematous background were specific to SA. Trichoscopy is highlighted as a non-invasive diagnostic tool to differentiate between SA and AA, potentially reducing the need for invasive biopsies. Despite its potential, the study's retrospective design and small sample size suggest the need for larger studies.

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