• ALI ABDULGHANI RAMADAN High Diploma Student, Dermatology, College of Medicine, University of Duhok, Kurdistan Region of Iraq.
  • HINDAV MIRDAN KHALEEL Assist. Professor, Medicine Department, College of Medicine, University of Duhok, Kurdistan Region of Iraq.
Keywords: Alopecia, Androgenetic alopecia, Hair loss, Telogen effluvium, Trichoscopy



Background: Alopecia, is a major condition that affects both sexes and people of all ages. Hair loss is the most common reason for women to consult a dermatologist, apparently because of cosmetic reasons. Androgenetic alopecia and Telogen Effluvium have greater rates of occurrence and sensitive responsiveness to timely treatments. Trichoscopy helps in diagnosis, determining the biopsy location, and providing prognostic information. Dermatologists can examine the scalp with a handheld dermoscope (x10 magnification). Vascular patterns, follicular and perifollicular features, and hair shaft features are among the dermoscopy results.

Objective: To compare the prevalence of trichoscopic characteristics of the scalp in Androgenic Alopecia and Telogen Effluvium on the basis of follicular patterns, interfollicular patterns, and hair features.

Methods: The study is a cross-sectional study conducted at the Azadi teaching hospital, in the Department of Dermatology, Venereology from December 2021 to May 2022, on a total sample size of 80 patients diagnosed clinically to estimate the prevalence of trichoscopic characteristic differences in each androgenetic alopecia and telogen effluvium using the Dermlite DL4 dermoscope, which allows for 10-fold magnification of the examining area .

Results: Among the eighty cases, 40 cases had Androgenetic alopecia and 40 had telogen effluvium.  In telogen effluvium, heterogeneity in hair shaft diameter in frontotemporal areas (15%), vellus hair (32.5%), Up growing hair (65%), 1-2 hair per follicle (17.5%), 3-multiple hair per follicle (82.5%), Yellow spots (5%), peripilar sign (20%), and are some of the most common results. in patients with Androgenetic alopecia, the distinguishing observation is that hair shaft diameter variation is common in the fronto-temporal and occipital regions (100% percent). Increase in number of miniaturized hair more than 20% is (97.5%), vellus hair (70%), upgrowing hair (27%), 1-2 hair per follicle (60%), 3- multiple hair per follicle (40%), yellow spots (57.5%) and Peripilar sign (35%) are all follicular characteristics found with androgenetic alopecia.

Conclusion: Trichoscopy is a good tool for differentiation between the two diffused alopecia androgenic alopecia and telogen effluvium. On Trichoscopy, in androgenetic alopecia the fronto-temporal zones had the most variation in hair shaft diameter. The peripilar sign, yellow spots, and empty hair follicles were the most common follicular features. Miniaturized hair was the most common hair shaft pattern seen androgenetic alopecia. On Trichoscopy, telogen effluvium is described as disease of exclusion needs further research. It's vital to distinguish this disorder from androgenetic alopecia, which has hair shaft thickness variations in the fronto-temporal areas but none in the occipital.


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