Diagnostic Significance of High-Frequency Ultrasound Method of Skin Examination in Alopecia (with an analysis of clinical cases)

Hair loss is one of the most common problems with which patients turn to a trichologist. Researchers are actively searching for new methods for early differentiation of this disease, which will make it possible to identify the main pathologies contributing to its development and to initiate appropriate treatment. The article presents descriptions of clinical alopecia cases in two patients and the results of high-frequency ultrasound scalp examination. Resona 7 device (Mindray, China), a linear high-frequency L20-5u sensor with 18–23 MHz scanning frequency was used in scanning modes of two-dimensional gray-scale and color Doppler mapping with blood flow assessment in the skin thickness. The diagnosis of patients is made basing on complaints, anamnesis, objective data and the results of clinical examinations, Pull-test (tension test), hair pulling test, trichogram, dermatoscopy, laboratory tests, histological and high-frequency ultrasound examinations of the scalp. In individuals with alopecia, a violation of the scalp echo image in the area of hair growth disorder was characteristic: the differentiation of echo-layers was lost and the echogenicity of the layers of the dermis and hypodermis changed, a decrease in vascular signals was determined. Using the method of high-frequency ultrasound scalp examination, along with standard methods, enables to obtain additional diagnostic information about the state of anatomical healthy skin structure and in case of impaired hair growth on the head. At this, the data obtained allow us to assert that high-frequency scalp ultrasound, unlike trichoscopy, due to the possibility of assessing echogenicity, clarity of differentiating echo-layers of the dermis and hypodermis and hair follicles, qualitative indicators of vascular signals, can be recommended for use in the algorithm of skin examination in various forms of alopecia.