Trichoscopy of Cicatricial Alopecia in Fair and Dark Skin: A Multicenter International Study of the <scp>EADV</scp> Task Force on Hair Diseases and the <scp>IDS</scp> Task Force on Trichoscopy

BACKGROUND: Trichoscopy enhances diagnostic accuracy in primary cicatricial alopecias (PCA), yet comparative data on its application across diverse skin phototypes remain limited. OBJECTIVES: The aim of this study was to characterize trichoscopic features across various forms of PCAs and compare findings between fair and dark phototypes. METHODS: This is a descriptive, multicenter international study analyzing trichoscopic patterns in 1102 patients with PCAs across a range of ethnic backgrounds and skin phototypes. RESULTS: The absence of follicular openings was the most consistent trichoscopic finding across all phototypes. Notable variations in trichoscopic patterns were observed based on skin color. In both fair and dark phototypes, signs of clinical and trichoscopic activity were predominantly observed within the first five years of disease duration, when inflammation is typically more pronounced. CONCLUSIONS: Clinicians should be aware of trichoscopic variations both between and within the same PCA according to the phototype. Such awareness enhances the recognition and interpretation of trichoscopic features, particularly during the early and active stages of the disease, and helps guide the selection of optimal biopsy sites across PCA subtypes in both fair and dark skin. This approach can ultimately facilitate histopathological confirmation and support clinical decision-making.

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Publication Details

Journal
International Journal of Dermatology
Published
2026-05-01
DOI
https://doi.org/10.1111/ijd.70440
Primary Topic
Hair Growth and Disorders
Type
article
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article

Trichoscopy of Cicatricial Alopecia in Fair and Dark Skin: A Multicenter International Study of the EADV Task Force on Hair Diseases and the IDS Task Force on Trichoscopy

Eirini Kyrmanidou, Anita Takwale, A. Souissi, Soumil Khare et al.
International Journal of Dermatology
Hair Growth and Disorders
article

Trichoscopy of Cicatricial Alopecia in Fair and Dark Skin: A Multicenter International Study of the EADV Task Force on Hair Diseases and the IDS Task Force on Trichoscopy

Eirini Kyrmanidou, Anita Takwale, A. Souissi, Soumil Khare, Matilde Iorizzo, Adriana Rakowska, Anna Waśkiel‐Burnat, Mariame Meziane, Anne Kelly Leroy, Marwa Faik, Cintia Medeiros Martins, Maria Boziou, Nkechi Anne Enechukwu, Daniel Fernandes Melo, Zoé Apalla, Andrea Sechi, Federico Quadrelli, A.C. Katoulis, Azael Freites‐Martinez, Georgia Pappa, Dimitrios Ioannides, Awatef Kelati, Eduardo Corona-Rodarte, NCoza Dlova, Elizabeth Lazaridou, Michela Starace, Francesca Pampaloni, Bianca Maria Piraccini, Lidia Rudnicka, Fatimata Ly, Daniel Asz-Sigall
article en

Abstract

BACKGROUND: Trichoscopy enhances diagnostic accuracy in primary cicatricial alopecias (PCA), yet comparative data on its application across diverse skin phototypes remain limited. OBJECTIVES: The aim of this study was to characterize trichoscopic features across various forms of PCAs and compare findings between fair and dark phototypes. METHODS: This is a descriptive, multicenter international study analyzing trichoscopic patterns in 1102 patients with PCAs across a range of ethnic backgrounds and skin phototypes. RESULTS: The absence of follicular openings was the most consistent trichoscopic finding across all phototypes. Notable variations in trichoscopic patterns were observed based on skin color. In both fair and dark phototypes, signs of clinical and trichoscopic activity were predominantly observed within the first five years of disease duration, when inflammation is typically more pronounced. CONCLUSIONS: Clinicians should be aware of trichoscopic variations both between and within the same PCA according to the phototype. Such awareness enhances the recognition and interpretation of trichoscopic features, particularly during the early and active stages of the disease, and helps guide the selection of optimal biopsy sites across PCA subtypes in both fair and dark skin. This approach can ultimately facilitate histopathological confirmation and support clinical decision-making.

International Journal of Dermatology
Mohammed V University (MA), All India Institute of Medical Sciences Raipur (IN), National and Kapodistrian University of Athens (GR), Nnamdi Azikiwe University (NG), Aristotle University of Thessaloniki (GR), Medical University of Warsaw (PL), Gloucestershire Hospitals NHS Foundation Trust (GB), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Secretaría de Salud de Jalisco (MX), Hospital General Dr. Manuel Gea Gonzalez (MX), Azienda USL di Bologna (IT), Université Mohammed VI des Sciences et de la Santé (MA), Institute of Dermatology (TH), University General Hospital Attikon (GR), Hospital Venereal and Skin Diseases Thessaloniki (GR), Tunis El Manar University (TN), Universidad Europea de Madrid (ES), University of KwaZulu-Natal (ZA), Cheikh Anta Diop University (SN)
Peace, Justice and strong institutions
Openalex Percentile: Top 8%
Hair Growth and Disorders
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