Trichoscopy of scalp dysesthesia

Introduction Scalp dysesthesia is characterized by localized pruritus, burning sensations or even pain. Aim To describe characteristic trichoscopic features of scalp dysesthesia. Material and methods The study was a retrospective analysis (2010–2016) of 9 patients (8 females and 1 male; median age: 52 years; range: 38–66 years). A total of 61 trichoscopic images were analyzed by two independent evaluators. Results In all cases, oval or round areas covered with short hairs: broom hairs (77%; 7/9), block hairs (88%; 8/9), short hairs with trichorrhexis nodosa (78%; 7/9) were found. In 4 of 9 cases these areas were circumscribed by brownish linear discoloration. Background features included: areas lacking hair shafts (44%; 4/9) covered by wavy-shaped scaling, whitish areas with prominent perifollicular yellow discoloration and cloud vessels arranged around follicular openings and around empty follicles (33%, 3/9); focal brownish discoloration with darker wavy lines (78%; 7/9). Conclusions Trichoscopy can be helpful in establishing the diagnosis of scalp dysesthesia – broom hairs, block hairs and short hairs with trichorrhexis nodosa covering the alopecia patch, uniform in length, can be considered as characteristic for this condition.