Non-cicatricial Alopecia: Diagnosis Made Easy

Objectives: The study aimed to correlate the clinical and trichoscopic features of non-cicatricial alopecia (NCA) and to evaluate the effectiveness of trichoscopy in aiding the final diagnosis, particularly in clinically ambiguous cases. Materials and Methods: After obtaining approval from the ethics committee, 329 patients with alopecia attending the Department of Dermato-Venereology and Leprology were enrolled in the study. A detailed history was obtained, followed by a thorough clinical examination. Trichoscopy was performed using a non-polarised eScope at ×20 magnification. Light microscopy and skin punch biopsy were carried out wherever indicated. Data analysis was conducted using STATA version 14.0. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. The association between NCA and other study parameters was assessed using the Chi-square test; Fisher’s exact test was applied where appropriate for small sample sizes. A p < 0.05 was considered statistically significant. Results: Alopecia areata was the most common cause of NCA (39.2%), followed by telogen effluvium (TE) and chronic TE (15.8%) and androgenetic alopecia (15.2%). Black dots, yellow dots, short vellus hair, thin hair, hair diameter diversity and exclamation mark hairs showed a highly significant association with different subtypes of NCA ( p < 0.001). Trichoscopy aided in the diagnosis of 93 (28.2%) unclear cases of NCA. Conclusion: The findings highlight the clinical utility of trichoscopy in improving diagnostic accuracy. However, limitations include single-observer interpretation and a lack of diagnostic validation against a gold standard in all cases. Clinically, trichoscopy serves as a valuable first-line adjunctive tool, particularly in ambiguous presentations.