The Analysis Of Related Factors To The Characteristic Dermoscopic Image Features Of Alopecia Areata

ObjectiveTo explore the related factors(stage,severity,duration,age,gender,etc.)to the characteristic dermoscopic features of alopecia areata(AA),which provide the basis for clinical diagnosis,judgments of curative effect and prognosis.MethodsThe clinical data of 180 patients with AA and the dermoscopic findings of areas of hair loss on the scalp wer'e collected and analyzed statistically for different clinical features such as stage,duration,severity,the TCM syndrome,age and gender.Resutls1.The most characteristic dermoscopic features of AA were black dot(78.9%of patients),broken hair(63.9%),exclamation mark hair(20.6%),clustered short vellus hair(83.9%)and yellow dot(79.4%).Black dot,short vellus hair,yellow dot were sensitive indicators for AA(99.40%of patients).2.The main TCM syndrome contained the liver and kidney deficiency syndrome(96 cases),spleen and kidney deficiency syndrome(72 cases),spleen deficiency syndrome(12 cases).There was statistically.significant difference in the incidence of short vellus hair between different syndromes.The incidence of short vellus hair with spleen deficiency syndrome was significantly lower than that of the other two syndromes.3.The incidence of short vellus hair in the remitting stage was 96.8%.The incidence of black dot,broken hair,short vellus hair and yellow dot in the progressive stage were respectively 88.7%,76.3%,82.5%and 85.6%.The incidence of black dot,broken hair and yellow dot in progressive stages were tatistically higher that of remitting stage.The incidences of black dot,broken hair and short vellus hair with short duration was statistically higher than that of long duration.The incidence of short vellus hair with severe AA was statistically lower than that of mild patients.4.The incidence of yellow dot of chidren with AA was statistically lower than that of adults,while the incidence of exclamation mark hair was the opposite.The incidences of black dot and broken hair of male were statistically higher than that of female.5.Black dots and broken hair were positively correlated with disease activity and male by multivariate logistic regression analysis.Short vellus hair was negatively correlated with disease activity and duration.Yellow dot was positively correlated with age of AA patients,while there was a negative correlation between the exclamation mark hairs and the age.Conclusions1.The most characteristic dermoscopic features of AA are black dot,broken hair,exclamation mark hair,clustered short vellus hair and yellow dot.Black dots,short vellus hairs and yellow dots are sensitive indicators for AA.2.Black dot and broken hair can be used as one of the indicators of disease activity for that they are positively correlated with disease activity.The shorter the duration,the faster hair follicle regenerate;Yellow dots are seldom found,while exclamation mark hairs are more commonly found in children with AA.The adults are the opposite.3.Short vellus hair is negatively correlated with disease activity,suggesting that the disease tends to recover;Short vellus hair is also correlated to the TCM syndromes.The lack of short vellus hairs tends to suggest spleen deficiency syndrome.These characteristic dermoscopic features of AA have great value in guiding for choices of treatment and the intervention measures.