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Abstract Dermoscopy is a noninvasive skin magnification technique, which allows a real in vivo subclinical exploration of the skin. Dermoscopy improves and completes clinical examination by revealing morphologic structures that are scarcely visible or invisible on the standard naked-eye physical examination. A dermatoscope used on the scalp to diagnose hair and scalp disorders is called a trichoscope. Trichoscopic tool could be handheld or digital. Magnification provided by a trichoscope is 10–100 fold or even higher. Trichoscopy involves examining the morphology of structure that are not visible to the naked eye, including perifollicular and interfollicular features and changes in the thickness and form of the hair shaft. Hair loss in children is a common complaint in dermatology clinics, and it is considered a challenge for dermatologists and pediatricians for reaching a proper diagnosis and therapy. In addition, this is an annoying problem for parents who worry about their children. Early management is needed, as it has an effect on normal physical and mental growth of children. The aim of this study was to elucidate the different dermoscopic characteristics of hair and scalp disorders in order to differentiate between them in pediatrics. So, all patients were subjected to: a- Informed consent. b- Complete history taking. c- Clinical examination (general and dermatological). d- Trichoscopic examination. The results of the study included: I- Clinical results ❖ Alopecias were detected in 69% of patients and divided into alopecia areata (patchy, ophiasis, totalis and universalis), patchy lesion of trichotillomania, tractional alopecia with positive fringe sign in some patients, lichen planopilaris with scary areas, androgenetic alopecia and telogen effluvium. ❖ Infectious hair and scalp disorders in 14% of patients and were included patchy lesions of tinea capitis which was the commonest infectious disorder, pediculosis that was diagnosed by presence of nits and lice, piedra that showed only when the hair was wet and wart that was easy to diagnosed clinically. ❖ Inflammatory hair and scalp disorders that included, psoriasis that had slivery white scales on erythematous background, seborrheic dermatitis that had greasy yellow scales with background erythema and dandruff. ❖ Acquired hair shaft disorders such as spilt ends and knots at the hair shaft. ❖ Congenital hair and scalp disorders as congenital triangular alopecia that was since birth and at the temporal areas, congenital hypotrichosis with decreasing in hair density, short anagen hair syndrome patient that clinically had normal hair shafts and normal density, monilethrix patient with decreasing in hair density and hair shafts appeared abnormal and nevus sebaceous that was present since birth with brownish verrucous like lesion. II- Dermoscopic results ❖ Alopecia areata had vellus hair, black dots and exclamation marks as common dermoscopic findings, but tapering hair, regrowing hair, yellow dots and arborizing blood vessels were exclusive features. Trichotillomania patients had diagnostic features as different hair length, v shaped hair, tulip hair, brush hair and flame hair. ❖ Tractional alopecia patients had vellus hair with white dots at the site of traction. ❖ Lichen planopilaris patient had peripilar cast with brownish greyish background and scary areas. ❖ Androgenetic alopecia patients had hair shaft diversity and peripilar signs as diagnostic features. ❖ Telogen effluvium patients didn’t have specific signs by dermoscopy. ❖ Tinea capitis patients had diagnostic signs as comma hair, zigzag hair, morse code hair and corkscrew hair associated with other signs like black dots and scales. ❖ Patients with pediculosis had the same clinical findings. ❖ Patient with piedra was diagnosed by presence of whitish masses encircle the hair shaft. ❖ Patient with wart was diagnosed clinically and confermed dermoscopically by presence of finger like projections with bleeding spots. ❖ Psoriatic patients were diagnosed dermoscopically by slivery white scales and regularly arranged dotted blood vessels. ❖ Seborrheic dermatitis patients were diagnosed by presence of greasy yellow scales on erythematous background. ❖ Dandruff was diagnosed by scales without signs of inflammation. ❖ Trichopitilosis and trichonodosis were dermoscopic findings in patients with acquired hair shaft disorders. ❖ Congenital triangular alopecia patients had vellus hair and regularly arranged white dots. Summary and Conclusions 127 ❖ Congenital hypotrichosis patients that had decreasing in the hair density and increasing vellus hair with white dots and patches. These patients needed further examination such as microscopic examination of the hair shaft. ❖ Short anagen hair syndrome, no specific finding, only vellus hair, white vellus hair, single follicular units and diffuse white loose scales were detected. ❖ Monilethrix patient had diagnostic features as elliptical nodes and multiple constrictions along the hair shaft. ❖ Patient with nevus sebaceous was diagnosed by presence of yellowish-brown globules with cobble stone appearance. |