Significance of dermoscopy in acute diffuse and total alopecia of the female scalp: review of twenty cases

Dermatology. 2008;217(4):333-6. doi: 10.1159/000155644. Epub 2008 Sep 18.


Background: Acute diffuse and total alopecia of the female scalp (ADTAFS) is a new subtype of alopecia areata that is characterized by rapid progression of diffuse alopecia of the female scalp, marked female predominance and a favorable prognosis. Differential diagnosis of other types of diffuse alopecia such as female pattern hair loss (FPHL) is necessary in some cases.

Objective: To describe dermoscopic findings of ADTAFS and to investigate the possibility of utilizing dermoscopy as a diagnostic tool for ADTAFS.

Methods: Twenty cases of ADTAFS diagnosed by clinical and/or histological findings were examined by dermoscopy.

Results: Cadaverized hairs (black dots), exclamation mark hairs (tapering hairs), broken hairs or yellow dots were seen in 18, 13, 19 and 17 out of 20 cases, respectively. One of these signs was seen in all cases (20/20). On the other hand, none of 12 cases with exclusively FPHL showed the dermoscopic features such as cadaverized hairs, exclamation mark hairs or broken hairs. Only 1 FPHL patient showed a yellow dot in the hair loss area.

Conclusion: Dermoscopy is a helpful diagnostic tool for ADTAFS, especially to distinguish it from FPHL.

MeSH terms

  • Acute Disease
  • Administration, Cutaneous
  • Administration, Oral
  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Alopecia / diagnosis*
  • Alopecia / drug therapy
  • Alopecia Areata / diagnosis
  • Dermoscopy* / methods
  • Diagnosis, Differential
  • Female
  • Hair / pathology*
  • Humans
  • Injections, Intravenous
  • Middle Aged
  • Retrospective Studies
  • Scalp Dermatoses / diagnosis
  • Scalp Dermatoses / drug therapy
  • Sensitivity and Specificity
  • Treatment Outcome


  • Adrenal Cortex Hormones