A Cross-sectional Observational Study to Correlate the Trichoscopic Findings of Female Pattern Hair Loss with the Disease Severity and Underlying Histopathological Changes.

Background: The increasing prevalence of female pattern hair loss (FPHL) is an alarming concern. Trichoscopy is an important bedside diagnostic tool for the diagnosis of FPHL, but there are very few studies correlating it with disease severity or histopathological findings which would provide a better insight to the treating clinician. Hence, we decided to take up this study.

Aim: This study aimed to study the trichoscopic findings of FPHL and correlate their relationship with disease severity and histopathological finding in our tertiary care hospital.

Materials and methods: Ninety females attending the dermatology outpatient department who were clinically diagnosed with FPHL were included in the study after informed consent and clearance from the institutional ethics committee. This was followed by a detailed history, clinical examination, and trichoscopic assessment. A trichoscopy-guided biopsy was performed from two sites. After the data collection, the statistical software used was IBM SPSS version 21.0 and Microsoft Office Excel 2007. P < 0.05 was accepted as indicative of statistical significance.

Results: Anisotrichosis, increased interfollicular distance, and decreased hairs per follicular unit were universal. Brown peripilar sign had a positive association with inflammation (P < 0.0005) and white peripilar sign with duration of disease and fibrosis whereas dartboard sign had a significant association with inflammation as well as fibrosis.

Conclusion: Trichoscopy helps in diagnosing the condition, assessing the severity, and monitoring the response to treatment. A knowledge about the features underlying specific trichoscopic signs such as inflammation and fibrosis would help the clinician decide the line of management.