Reliability of Trichoscopy in the Diagnosis of Scalp Discoid Lupus Erythematosus and Lichen Planopilaris

Dindar Sharif Qurtas; Renas Dlzar Tofiq; Sangar Jalal Othman

Reliability of Trichoscopy in the Diagnosis of Scalp Discoid Lupus Erythematosus and Lichen Planopilaris

Dindar Sharif Qurtas, Renas Dlzar Tofiq, Sangar Jalal Othman

Abstract

Background: Scarring alopecia is common dermatological disorders in Iraq. The differentiation of the dermatoses among the differential diagnoses of scarring alopecia disorders is difficult especially at earlier stages that needs for new accurate diagnostic tools. Aim of the study is to assess the reliability of trichoscopy for the diagnosis of scalp discoid lupus erythematosus (DLE) and lichen planopilaris (LPP).

Patients and methods: A prospective cross-sectional study conducted for forty patients with scarring alopecia in Erbil Dermatology Teaching Center over a period of one year from February 2022 to February 2023. The diagnosis of scarring alopecia and differentiations between DLE and LPP were done by two specialist dermatologists in regard to findings of clinical, trichoscopy and histopathology.

Results: Clinically, 26 (65%) patients with scarring alopecia were diagnosed as LPP, while 14 (35%) patients were diagnosed as DLE. According to trichoscopy, 24 (60%) patients with scarring alopecia were diagnosed as LPP, while 16 (40%) patients were diagnosed as DLE. Histopathology results identified that 23 (57.5%) patients with scarring alopecia were diagnosed as LPP, while 17 (42.5%) patients were diagnosed as DLE. The validity findings of trichoscopy in comparison to histopathology in diagnosis of LPP were: sensitivity 87%, specificity 76.5%, NPV 81.3%, PPV 81.3% and accuracy 82.5%, while validity findings of trichoscopy in comparison to histopathology in diagnosis of DLE were: sensitivity 76.5%, specificity 87%, NPV 81.3%, PPV 83.3% and accuracy 82.5%.

Conclusions: trichoscopy is a valid and reliable diagnostic technique for scarring alopecia disorders and differentiation between scalp LPP and DLE.

Keywords

Trichoscopy, Scarring alopecia, Scalp lichen planopilaris, Discoid lupus erythematosus.

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