Trichoscopy as a Useful Tool to Diagnose Telogen Effluvium

Objective: To determine the efficacy of Trichoscopy in diagnosing telogen effluvium (TE) at a tertiary care Hospital. Methodology: This cross-sectional study was conducted in Dermatology department, PNS Shifa Hospital, Karachi from December 2022 to May 2023. Overall 100 individuals with clinically confirmed telogen effluvium of either gender were included. Individuals with TE underwent trichoscopic imaging of the frontal, vertex, temporal, and occipital scalp using the HEINE DELTA 20T dermoscope without liquid media. High-resolution images and videos were captured and independently evaluated by two expert dermatologists to ensure diagnostic utility. The SPSS version 26 statistical analysis program was used for data entry and analysis. Results: The mean age of the patients was 32.7 ± 8.4 years, with mean disease duration of 4 ± 2 months. Among the 100 patients, 47 (47%) were men, and 53 (53%) were women. Perifollicular scaling (95%) was the most frequent trichoscopic finding in our study, followed by hair diameter diversity (48%), vellus hair (42%), perifollicular pigmentation (33%), and yellow spots and scalp discoloration (27%). Trichoscopic findings in telogen effluvium showed significant differences between frontal and occipital regions. Vellus hair, HDD, yellow dots, perifollicular pigmentation and Perifollicular scaling were significantly more common in the frontal area, while scalp discoloration was significantly higher in the occipital region (p=<0.05). Conclusion: Trichoscopy has proven to be an effective, non-invasive diagnostic tool for identifying telogen effluvium. Comparing trichoscopic findings between the frontal and occipital regions helps differentiate telogen effluvium from androgenetic alopecia, enabling early and accurate diagnosis while minimizing the need for invasive procedures.