Trichoscopic Features of Scalp Psoriasis: Their Association With Disease Severity and Quality of Life in a Hispanic Population.

Abstract

Background: Scalp psoriasis is a common condition that impairs quality of life (QoL). Trichoscopy is a valuable tool for diagnosis, but its correlation with disease severity or patient-reported outcomes, especially in Hispanic populations, remains unclear due to limited data. This study aimed to characterize the trichoscopic findings of scalp psoriasis in a Hispanic cohort and to evaluate their association with clinical severity and QoL measures.

Methods: We conducted a cross-sectional study in Hispanic adults with scalp psoriasis. Participants underwent a comprehensive clinical assessment, involving the Psoriasis Scalp Severity Index (PSSI), the Dermatology Life Quality Index (DLQI), and the Scalp-Specific Dermatology Life Quality Index (SCALPDEX). Standardized trichoscopic images were captured from five scalp regions and analyzed for characteristic vascular patterns. Multiple linear regression analyses were used to identify associations between trichoscopic findings and clinical outcomes.

Results: Among the 81 participants (mean age 40 ± 13.65 years, 50.6% female), twisted red loops were the most frequent vascular pattern (64-84% across regions), which significantly correlated with elevated PSSI, Videodermoscopy Scalp Psoriasis Severity Index (VSCAPSI), and DLQI scores (p < 0.05). Hemorrhagic dots in the parietal regions were associated with higher QoL impairment (DLQI: +5 points; SCALPDEX: +17.1 points, p < 0.01). Females reported greater scalp-specific symptom burden despite lower objective severity scores.

Conclusion: In this cohort, specific trichoscopic findings were associated with increased clinical severity and impaired QoL. These preliminary findings suggest that trichoscopy can serve as a complementary tool for a more holistic assessment. Longitudinal studies are needed to validate trichoscopic features as biomarkers of disease activity and treatment response.