Relevance of Trichoscopy in Differential Diagnosis of Focal Non-cicatricial Alopecia in Children

Study Overview
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Brief Summary
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Alopecia is a common, distressing condition that is sometimes difficult to diagnose and treat. Losing hair is not usually health threatening; it can scar a young child's vulnerable self-esteem by causing immense psychological and emotional stress, not only to the patient, but also to the concerned parents and siblings; so the cause of hair loss should be diagnosed and treated early to overcome the resulting problems.

Detailed Description
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The majority of alopecia in children is presented as patchy alopecia, which is most commonly diagnosed as alopecia areata. However, other causes of patchy alopecia such as tinea capitis, trichotillomania, temporal triangular alopecia (TTA), nevus sebaceous and aplasia cutis congenita (ACC) can be easily missed. Trichoscopy (hair and scalp dermoscopy) is a non-invasive diagnostic tool that allows the recognition of morphologic structures not visible by the naked eye. Trichoscopy allows visualization of hair shafts at high magnification and performing measurements, such as hair shaft thickness, without the need of removing hair for diagnostic purposes. It also allows in vivo visualization of the epidermal portion of hair follicles and perifollicular epidermis. The advantages of trichoscopy in evaluating hair loss in children are numerous, as it is a fast in-office technique , non-invasive, inexpensive, and painless , and therefore it will be accepted by children and their parents. Tinea capitis and alopecia areata are considered to be the most common causes of hairless patches of the scalp in pediatrics. Tinea capitis especially non-scaly type may have the same clinical appearance of alopecia areata, so trichoscopy has recently become a useful diagnostic tool for alopecia areata and tinea capitis, especially in doubtful cases as lab investigations like fungal culture or biopsy may take several weeks.

Official Title
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Relevance of Trichoscopy in Differential Diagnosis of Focal Non-cicatricial Alopecia in Children

Conditions
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Focal Non-cicatricial Alopecia

Intervention / Treatment
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* Device: Trichoscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: -age from 3-18 years of both sexes with focal non-cicatricial alopecia.(1-5 patches of alopecia) Exclusion Criteria: Patients who will not consent. uncooperative children. patients with active secondary bacterial infection in the alopecic patch. patients with any concomitant dermatological diseases. history of using any topical(1 month) or systemic treatment (3 month) for tinea capitis or alopecia areata prior to the study, cicatricial alopecia.

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| children with Alopecia Areata<br> | Device: Trichoscopy<br>* Trichoscopy (hair and scalp dermoscopy) is a noninvasive diagnostic tool that allows the recognition of morphologic structures not visible by the naked eye Structures which may be visualized by trichoscopy include hair shafts of different types, the number of hairs in one pilosebaceous unit, hair follicle openings (dots), the peri and interfollicular areas and the vasculature.<br>|
| children with tinea capitis<br> | Device: Trichoscopy<br>* Trichoscopy (hair and scalp dermoscopy) is a noninvasive diagnostic tool that allows the recognition of morphologic structures not visible by the naked eye Structures which may be visualized by trichoscopy include hair shafts of different types, the number of hairs in one pilosebaceous unit, hair follicle openings (dots), the peri and interfollicular areas and the vasculature.<br>|
| children with trichotillomania<br> | Device: Trichoscopy<br>* Trichoscopy (hair and scalp dermoscopy) is a noninvasive diagnostic tool that allows the recognition of morphologic structures not visible by the naked eye Structures which may be visualized by trichoscopy include hair shafts of different types, the number of hairs in one pilosebaceous unit, hair follicle openings (dots), the peri and interfollicular areas and the vasculature.<br>|
| children with tractional alopecia<br> | Device: Trichoscopy<br>* Trichoscopy (hair and scalp dermoscopy) is a noninvasive diagnostic tool that allows the recognition of morphologic structures not visible by the naked eye Structures which may be visualized by trichoscopy include hair shafts of different types, the number of hairs in one pilosebaceous unit, hair follicle openings (dots), the peri and interfollicular areas and the vasculature.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sensitivity and specificity of the common trichoscopic findings in diagnosis of clinically difficult cases of focal non-cicatricial alopecia in children. | Characteristic trichoscopic findings will be searched for in each case such as (exclamation mark hairs, yellow and black dots) for alopecia areata. Flame hairs, tulip hairs, coiled hairs, hook hairs, v-sign and irregularly broken hairs for trichotillomania.Findings for tinea capitis (comma hairs, zigzag hairs, corkscrew hairs and block hairs).Coiled irregularly broken hairs and hair casts for tractional alopecia. | 2017-2018 |