Published: 2021-10-27

Clinical and dermoscopic patterns of childhood alopecia areata in a tertiary care centre in North India

Pooja Bains, Simplepreet Kaur


Background: To describe the clinico epidemiologic profile and dermoscopic findings in children with alopecia areata (AA) and correlate the dermoscopic findings with stage and severity.

Methods: The present study was performed over a period of six months, from July 2020 to December 2020 in a tertiary care hospital where 50 clinically diagnosed children ≤15 years with AA were enrolled. A thorough clinical examination followed by dermoscopy was performed. The results were tabulated and then analyzed statistically.

Results: The mean age of presentation was 9.74 years. The most common site involved was scalp and the most common dermoscopic findings were yellow dots (25/50, 50%), short vellus hair (22/50, 44%), black dots (21/50, 42%), exclamation mark hair (15/50, 30%) and broken hair (11/50, 22%).

Conclusions: No significant associations was found between dermoscopic findings and severity or stage of childhood alopecia areata. There was a significant correlation of alopecia areata severity with nail findings in children with alopecia areata.


Dermoscopy, Yellow dots, Black dots

Full Text:



Messenger AG, Sinclair RD, Farrant P, de Berker D. Acquired disorders of hair. In: Griffiths C,Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rooks’s Textbook of Dermatology. Ninth Edition. Oxford: Wiley Blackwell. 2016;89:1-89.

Fricke AC, Miteva M. Epidemiology and burden of alopecia areata: a systematic review. Clin Cosmet Investig Dermatol. 2015;8:397-403.

Wohlmuth-Wieser I, Osei JS, Norris D, Price V, Hordinsky MK, Christiano A et al. Childhood alopecia areata-Data from the National Alopecia Areata Registry. Pediatr Dermatol. 2018;35(2):164-9.

Bains P, Kaur S. The Role of Dermoscopy in Severity Assessment of Alopecia Areata: A Tertiary Care Center Study. J Clin Aesthet Dermatol. 2020;13(4):45-50.

Olsen EA, Hordinsky MK, Price VH, Roberts JL, Shapiro J, Canfield D et al. National Alopecia Areata Foundation. Alopecia areata investigational assessment guidelines--Part II. National Alopecia Areata Foundation. J Am Acad Dermatol. 2004;51(3):440-7.

Atluru NC, Gaddam V, Rangarajan S, Muralidhar K, Veeraraghavan M. A clinical profile of childhood alopecia areata in a Tertiary Care Hospital in Chennai, India. Indian J Paediatr Dermatol. 2019;20:320-4.

Nanda A, Al-Fouzan AS, Al-Hasawi F. Alopecia areata in children: A clinical profile. Pediatr Dermatol. 2002;19:482 5.

Tan E, Tay YK, Giam YC. A clinical study of childhood alopecia areata in Singapore. Pediatr Dermatol. 2002;19:298-301.

Sharma VK, Kumar B, Dawn G. A clinical study of childhood alopecia areata in Chandigarh, India. Pediatr Dermatol. 1996;13:372-7.

Xiao FL, Yang S, Liu JB, He PP, Yang J, Cui Y, et al. The epidemiology of childhood alopecia areata in China: A study of 226 patients. Pediatr Dermatol. 2006;23:13-8.

Hegde SP, Naveen KN, Athanikar SB, Reshme P. Clinical and dermatoscopic patterns of alopecia areata: a tertiary care centre experience. Int J Trichology. 2013;5(3):132-6.

Rakowska A, Maj M, Zadurska M, Czuwara J, Warszawik-Henzel O, Olszewska M et al. Trichoscopy of Focal Alopecia in Children - New Trichoscopic Findings: Hair Bulbs Arranged Radially along Hair-Bearing Margins in Aplasia Cutis Congenita. Skin Appendage Disord. 2016;2(1-2):1-6.

Moneib H, El-Shiemy S, Saudi W, El-Fangary M, Nabil T, Mohy S. Hair loss among a group of Egyptian children. Journal of the Egyptian Women's Dermatologic Society. 2017;14(1):9-24.

Waśkiel-Burnat A, Rakowska A, Sikora M, 16Olszewska M, Rudnicka L. Trichoscopy of alopecia areata in children. A retrospective comparative analysis of 50 children and 50 adults. Pediatr Dermatol. 2019;36(5):640-5.

El-Taweel AE, El-Esawy F, Abdel-Salam O. Different trichoscopic features of tinea capitis and alopecia areata in pediatric patients. Dermatol Res Pract. 2014;2014:848763.

Amer M, Helmy A, Amer A. Trichoscopy as a useful method to differentiate tinea capitis from alopecia areata in children at Zagazig University Hospitals. Int J Dermatol. 2017;56(1):116-20.