16.AlopeciaAreata-文字教案分析.docVIP

Alopecia Areata Abstract The hallmark trichoscopic features of alopecia areata are regularly distributed yellow dots, micro–exclamation mark hairs, tapered hairs, black dots, broken hairs, and upright and regularly coiled (circle, pigtail) regrowing hairs. Trichorrhexis nodosa may be observed, especially in active, early alopecia areata. It must be emphasized that micro–exclamation mark hairs are not pathognomonic for alopecia areata. Trichoscopy of alopecia areata may differ depending on disease activity, severity, and duration. The hallmark trichoscopic features of alopecia areata are regularly distributed yellow dots, micro–exclamation mark hairs, tapered hairs, black dots (formerly called cadaverous hairs), broken hairs, and regrowing upright or regrowing coiled hairs. Trichoscopy of alopecia areata may differ depending on disease activity, severity, and duration. These differences were evaluated in several studies during recent years. In 2004, Lacarrubba et al. [1] investigated 200 patients with alopecia areata, subdivided into acute and chronic disease. This study identi?ed three features of acute alopecia areata: micro–exclamation marks, black dots, and vellus hairs. In chronic alopecia areata of recent onset, the scalp skin was smooth and thin, with evident follicular openings. In cases of longstanding chronic alopecia areata, the hair follicle openings appeared to be obstructed by keratotic plugs. In some patients, trichoscopy revealed hair regrowth, with a homogeneous or sparse presence of pigmented regrowing hairs. These hairs differ from delicate, hypopigmented vellus hairs in their dark pigmentation and upright position. In a 2006 study in 58 patients with alopecia areata, Ross et al. [2] found yellow dots, exclamation mark hairs, black dots, and dystrophic hairs as the most characteristic trichoscopic features. These features were similarly expressed on trichoscopy of all investigated subgroups of alopecia areata: patchy, ophiasis, d