Is Trichoscopy A Reliable Method For Differantiation Of Frontal Non-Scarring Alopecias?

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Muhammed Ali Gökkaya, İjlal Erturan, Mehmet Yıldırım, Hikmet Orhan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8880023/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background : There is difficulty in the differential diagnosis of noncicatricial alopecia affecting the frontal scalp, and trichoscopy needs to be standardized to improve its accuracy and consistency. Objective : It is aimed to make differential diagnoses of tractional alopecia (TA), male pattern hair loss (MAGA), female pattern hair loss (FAGA) and telogen effluvium (TE) affecting frontal scalp with trichoscopy and to contribute to trichoscopic standardization. Methods : The frontal, vertex, temporal and occipital regions were evaluated trichoscopically. Results : The hair diameter diversity in the frontal region was significantly more common in the FAGA (90%), MAGA (100%), and TA (89.3%) groups (p<0.001), and was significantly more common in the FAGA (86.7%) and MAGA (76.5%) groups in the vertex (p<0.001), and was significantly more common in the TA (71.4%) group in the temporal region (p<0.001). The mean number of single follicular unit finding in the FAGA (10.70 ± 6.59), MAGA (13.12 ± 9.05), and TA (9.21 ± 3.99) groups were significantly higher in the frontal region (p<0.001). Limitations : The single center design and small sample size are limitations of the study. Conclusion : Since the number, occurrence rate, and location of trichoscopic findings are important, trichoscopic evaluation should include all areas of the scalp. Alopecia trichoscopic findings hair scalp Capsule summary ( First bullet ) Trichoscopy is used for diagnosing and following-up hair diseases; it is a rapid and non-invasive technique but needs to be standardized for improving its accuracy and consistency. ( Second bullet ) Since the number, occurrence rate, and location of trichoscopic findings are important, trichoscopic evaluation should include all areas of the scalp. INTRODUCTION Alopecia is a common condition that often leads to psychological stress. Physicians may have difficulties in a specific diagnosis (1). Scarring and non-scarring alopecia have been identified. Non-scarring alopecia is a more common condition, while scarring alopecia is rarer and is characterized by permanent hair loss (2). Despite trichoscopy, also known as hair and scalp dermatoscopy, is a non-invasive, easy and well accepted method in diagnosis, treatment monitoring and following up alopecias (3–6), is an underdeveloped technique needs to be standardized and be improved for its accuracy and consistency. Difficulties may arise due to non-standardized terminology and to differences in skin phototype and hair color. The aim of the present study is to be able to differantiate traction alopecia (TA), female pattern hair loss (FAGA), male pattern hair loss (MAGA), telogen effluvium (TE) with trichoscopic findings and to contribute to trichoscopic standardization. MATERIALS AND METHODS Between December 2023-May 2024, 107 patients aged 18–65 years with frontal non-scarring alopecia were enrolled to the study. The study was approved by the Clinical Research Ethics Committee of Süleyman Demirel University Faculty of Medicine, and written informed consent were obtained from the all partipicants. Patients with uncontrolled systemic or chronic dermatologic diseases were excluded. Diagnoses were based on clinical findings and/or scalp biopsy. Demographic and clinical data, skin phototype, and hair styling practices were recorded. Standardized clinical photographs and trichoscopic images of the frontal, vertex, temporal, and occipital scalp regions were obtained using a FotoFinder Medicam 1000 videodermatoscope. Four trichoscopic images at 20x magnification were recorded by the same physician for each region. Average number of certain trichoscopic findings (single follicular unit, broken hair, black dot, vellus hair, thin hair, white dot, yellow dot) were calculated (each area at 20x magnification was 0.9 mm²) for each region. Statistical Analysis Data were analyzed with SPSS version 29.0. Descriptive statistics were presented as mean ± standard deviation. Categorical variables were given as numbers and percentages. Comparisons of categorical data were performed by the Pearson chi-square test. The normality of continuous variables was analysed with Kolmogorov-Smirnov and Shapiro-Wilk test. The Bonferroni correction test was used for pairwise comparisons of the four groups and a p-value < 0.05 was considered statistically significant. RESULTS The study included a total of 100 patients diagnosed with 30 FAGA, 17 MAGA, 28 TA, 25 TE. The demographic and clinical features of the patient group were presented in table 1. The mean number of single follicular unit finding in the FAGA (10.70 ± 6.59), MAGA (13.12 ± 9.05), and TA (9.21 ± 3.99) groups were significantly higher in the frontal region (p < 0.001), and was significantly higher in the vertex in the FAGA (8.30 ± 5.68) and MAGA (8.65 ± 9.61) groups (p < 0.001). The mean number of vellus hair finding in the frontal region was significantly higher in the MAGA (16.18 ± 13.12) group (p < 0.001), was significantly higher in the vertex in the FAGA (2.33 ± 3.04) and MAGA (7.53 ± 8.21) groups (p < 0.001). The hair diameter diversity in the frontal region was significantly more common in the FAGA (90%), MAGA (100%), and TA (89.3%) groups (p < 0.001), and was significantly more common in the FAGA (86.7%) and MAGA (76.5%) groups in the vertex (p < 0.001), and was significantly more common in the TA (71.4%) group in the temporal region (p < 0.001). Vascular pattern characteristics were similar among the groups. Comparison of groups in terms of trichoscopic findings were shown in Table 2 and Table 3. Table 1 Demographic Features of Patients According to Diagnoses FAGA MAGA TA TE FFA TTM Total n (%) 30 (28,0) 17 (15,9) 28 (26,2) 25 (23,4) 3 (2,8) 4 (3,7) 107 Female 30 0 27 23 3 4 87 Male 0 17 1 2 0 0 20 Age \(\:\stackrel{-}{\varvec{X}}\pm\:\varvec{S}\) 38,77 ± 14,46 32,29 ± 12,12 35,61 ± 2,41 31,00 ± 11,19 37,6 ± 12,74 26,7 ± 10,68 Duration of disease \(\:\stackrel{-}{\varvec{X}}\pm\:\varvec{S}\) 7,38 ± 6,75 6,26 ± 4,78 5,71 ± 5,08 1,95 ± 2,17 2,66 ± 0,57 3,25 ± 0,95 \(\:\stackrel{-}{\varvec{X}}\pm\:\varvec{S}\) : Mean and Standard Deviation, FAGA: Female pattern hair loss, MAGA: Male pattern hair loss, TA: Traction alopecia, TE: Telogen effluvium, FFA: Frontal fibrosing alopecia, TTM: Trichotillomania Table 2 Comparison of Diagnostic Groups in Terms of Trichoscopic Findings Trichoscopic Findings n (%) FAGA MAGA TA TE p * Regrowing Hair Frontal 10 a (33,3) 4 a (23,5) 19 b (67,9) 23 c (92,0) < 0,001 Regrowing Hair Vertex 6 a (20,0) 3 a (17,6) 4 a (14,3) 15 b (60,0) 0,001 Regrowing Hair Temporal 7 a, b (23,3) 2 b (11,8) 13 a (46,4) 20 c (80,0) < 0,001 Hair Powder Frontal 0 a (0,0) 1 a, b (5,9) 5 b (17,9) 0 a (0,0) 0,015 Hair Powder Vertex 0 (0,0) 0 (0,0) 0 (0,0) 0 (0,0) ≌1 Hair Powder Temporal 0 (0,0) 0 (0,0) 2 (7,1) 0 (0,0) 0,155 Hair Diameter Diversity Frontal 27 a (90,0) 17 a (100,0) 25 a (89,3) 9 b (36,0) < 0,001 Hair Diameter Diversity Vertex 26 a (86,7) 13 a (76,5) 1 b (3,6) 6 c (24,0) < 0,001 Hair Diameter Diversity Temporal 18 a, b (60,0) 6 b, c (35,3) 20 a (71,4) 7 c (28,0) 0,006 Lonely Hair 1 a (3,3) 15 b (88,2) 2 a (7,1) 2 a (8,0) < 0,001 Focal Atrichia Frontal 25 (83,3) 16 (94,1) 25 (89,3) 17 (68,0) 0,100 Focal Atrichia Vertex 20 a (66,7) 12 a, b (70,6) 6 c (21,4) 10 b, c (40,0) 0,001 Focal Atrichia Temporal 20 (66,7) 7 (41,2) 18 (64,3) 12 (48,0) 0,230 Absence of Follicular Openings Frontal 14 a (46,7) 15 b (88,2) 21 b (75,0) 8 a (32,0) < 0,001 Absence of Follicular Openings Vertex 17 a (56,7) 11 a (64,7) 3 b (10,7) 2 b (8,0) < 0,001 Absence of Follicular Openings Temporal 10 a (33,3) 5 a (29,4) 18 b (64,3) 5 a (20,0) 0,006 Peripilar Sign Frontal 7 (23,3) 7 (41,2) 5 (17,9) 4 (16,0) 0,232 Peripilar Sign Vertex 2 a, b (6,7) 4 b (23,5) 1 a (3,6) 0 a (0,0) 0,023 Peripilar SignTemporal 5 (16,7) 4 (23,5) 2 (7,1) 1 (4) 0,179 Honeycomb Pigment Pattern Frontal 17 (56,7) 11 (64,7) 15 (53,6) 8 (32,0) 0,148 Honeycomb Pigment Pattern Vertex 10 a, b (33,3) 9 b (52,9) 4 a (14,3) 4 a (16,0) 0,017 Honeycomb Pigment Pattern Temporal 6 (20,0) 7 (41,2) 11 (39,3) 8 (32,0) 0,344 İnterfolicular Scale Frontal 4 a (13,3) 2 a (11,8) 11 b (39,3) 11 b (44,0) 0,016 İnterfolicular Scale Vertex 7 (23,3) 2 (11,8) 12 (42,9) 8 (32,0) 0,130 White Patch Frontal 1 a (3,3) 0 a (0,0) 10 b (35,7) 0 a (0,0) < 0,001 White Patch Vertex 1 (3,3) 1 (3,6) 0 (0,0) 1 (4,0) 0,694 White Patch Temporal 1 a (3,3) 0 a (0,0) 10 b (35,7) 0 a (0,0) 0.05). FAGA: Female pattern hair loss, MAGA: Male pattern hair loss, TA: Traction alopecia, TE: Telogen effluvium Table 3. Comparison of Diagnostic Groups with Trichoscopic Findings (Mean and Standard Deviation) Trichoscopic Findings FAGA \(\:\stackrel{-}{\varvec{X}}\pm\:\varvec{S}\) MAGA \(\:\stackrel{-}{\varvec{X}}\pm\:\varvec{S}\) TA \(\:\stackrel{-}{\varvec{X}}\pm\:\varvec{S}\) TE \(\:\stackrel{-}{\varvec{X}}\pm\:\varvec{S}\) p * Single Follicular Unit Frontal 10,70 ± 6,59 13,12 ± 9,05 9,21 ± 3,99 4,16 ± 2,88 < 0,001 Single Follicular Unit Vertex 8,30 ± 5,68 8,65 ± 9,61 2,18 ± 2,80 3,60 ± 2,42 < 0,001 Single Follicular Unit Temporal 7,80 ± 5,36 6,00 ± 7,22 7,18 ± 4,10 4,80 ± 4,00 0,051 Broken Hair Frontal 0,00 ± 0,00 0,00 ± 0,00 0,46 ± 0,84 0,00 ± 0,00 < 0,001 Broken Hair Vertex 0,00 ± 0,00 0,00 ± 0,00 0,00 ± 0,00 0,00 ± 0,00 ≌1 Broken Hair Temporal 0,00 ± 0,00 0,00 ± 0,00 0,00 ± 0,00 0,00 ± 0,00 ≌1 Black Dot Frontal 0,07 ± 0,25 0,24 ± 0,66 0,61 ± 0,92 0,08 ± 0,28 0,007 Black Dot Vertex 0,00 ± 0,00 0,00 ± 0,00 0,00 ± 0,00 0,00 ± 0,00 ≌1 Black Dot Temporal 0,00 ± 0,00 0,00 ± 0,00 0,21 ± 0,57 0,00 ± 0,00 0,014 Vellus Hair Frontal 4,63 ± 5,92 16,18 ± 13,12 6,11 ± 4,55 1,16 ± 2,49 < 0,001 Vellus Hair Vertex 2,33 ± 3,04 7,53 ± 8,21 0,21 ± 0,63 0,16 ± 0,55 < 0,001 Vellus Hair Temporal 2,10 ± 3,06 6,00 ± 4,91 4,11 ± 3,35 0,20 ± 1,00 < 0,001 Thin Hair Frontal 14,30 ± 7,55 16,35 ± 8,35 12,07 ± 5,08 5,84 ± 4,42 < 0,001 Thin Hair Vertex 12,23 ± 5,36 13,00 ± 9,27 4,32 ± 2,80 4,92 ± 3,95 < 0,001 Thin Hair Temporal 10,00 ± 5,53 6,88 ± 4,48 9,75 ± 5,32 5,56 ± 4,07 0,005 White Spot Frontal 1,27 ± 1,87 1,12 ± 1,36 1,71 ± 1,24 0,92 ± 1,63 0,060 White Spot Vertex 1,37 ± 2,34 0,76 ± 1,03 0,07 ± 0,26 0,32 ± 0,99 0,002 White Spot Temporal 0,87 ± 1,47 0,29 ± 0,68 1,18 ± 1,09 0,44 ± 1,04 0,013 Yellow Spot Frontal 1,10 ± 1,52 0,88 ± 1,32 1,25 ± 1,82 0,88 ± 1,05 0,946 Yellow Spot Vertex 0,70 ± 1,18 0,76 ± 1,30 0,29 ± 0,66 0,24 ± 0,72 0,146 Yellow Spot Temporal 0,50 ± 1,11 0,29 ± 0,69 0,71 ± 1,36 0,08 ± 0,40 0,123 * Kruskal-Wallis Testi, \(\:\stackrel{-}{\varvec{X}}\pm\:\varvec{S}\) : Mean and Standard Deviation, FAGA: Female pattern hair loss, MAGA: Male pattern hair loss, TA: Traction alopecia, TE: Telogen effluvium DISCUSSION Trichoscopy is becoming an increasingly important technique in the differential diagnosis of cicatricial and non-cicatricial alopecias. Trichoscopic differential diagnoses of patients with non-cicatricial hair loss in the frontal area will be discussed here. All patients’ included in the study, mean age results were consistent with the literatüre (7–11). On a healthy scalp, mean number of 2–4 terminal hair, emerge from a single follicular unit (9). Increase in the number of single hair follicular unit is considered a sign of early-stage androgenetic alopecia and is one of the common findings of TA (5). The rate of single follicular unit finding in the frontal region was reported to be significantly higher in FAGA group (65%) compared to TE group (39%) and healthy controls (27%) (9). While the mean number of single hair follicular unit finding in the frontal region was significantly higher in the FAGA (10.70 ± 6.59), MAGA (13.12 ± 9.05) and TA groups (9.21 ± 3.99), the mean number of single hair follicular units in the vertex was significantly higher in the FAGA (8.30 ± 5.68) and MAGA (8.65 ± 9.61) groups in the present study. Since TA usually involves the frontotemporal region, the mean number of single follicular unit finding in the vertex is expected to be lower than that in the frontal region. The mean number of single hair follicular unit finding may support FAGA, MAGA, and TA in the frontal region, FAGA and MAGA in the vertex. Vellus are shorter (<3mm), thinner (<0.003mm), blunt-ended, hypopigmented, and wavy shaped hairs without medulla an indicator of severe miniaturization of androgenetic alopecia (12). Numerous vellus hairs might be seen in TA since they are too short to undergo mechanical trauma (6, 13). In a study comparing groups that had worn turbans for >10 years and <10 years, vellus hair was detected in all patients diagnosed with TA (11), and in another study vellus hair was detected in 44% of AGA patients (10). In the present study, the mean number of vellus hair finding was significantly higher in the frontal and temporal regions in the MAGA, FAGA, and TA groups, also vellus hair finding was significantly higher in the FAGA and MAGA groups in the vertex. Mean number of vellus hairs may distuinguish FAGA and TA from TE in the frontal and temporal regions, also FAGA from TA in the vertex. Additionally, the mean number of vellus hair finding in the frontal and temporal regions were significantly higher in MAGA than in FAGA groups indicating more prevalent miniaturization in men than in women. To our knowledge, there is no study comparing the vellus hair finding in FAGA and MAGA numerically. The hair diameter diversity or anisotrichosis refers to the variability in hair schaft diameter. (6). There is no consensus on whether hair diameter variation of more than 20% in male and female patients (7, 8, 10) or more than 20% in males and more than 10% in females should be considered as diagnostic criteria for AGA (12). The hair diameter diversity was significantly higher in the FAGA (90%), MAGA (100%) and TA (89.3%) patients in the frontal region, higher in the TA (71.4) and FAGA (60%) patients in the temporal region, higher in the FAGA (86.7%) and MAGA (76.5%) patients in the vertex. The evaluation of regional hair diameter diversity may be useful in differential diagnosis of alopecias. TA is generally observed in the frontotemporal scalp and hair shaft diameter diversity is one of the primary trichoscopic findings (11,14). TA may occur due to hair styles causing prolonged tension of the hair (14, 15). Turban use can cause traction (14) and significant increase in trichoscopic findings belonging to TA as the duration of turban use increases (11). In the present study, the habit of tight hair styling was significantly more common in the TA group. Regrowing hair refers to short hair growing upright, thinner and tapered at the distal end (3,9,12,16). Regrowing hair is the most common but not specific trichoscopic finding of TE (3,5,17,18) and is suggested to be an important indicator for chronic TE (9). Consistent with the literature, regrowing hair finding was most frequently observed in the TE group in all three regions and was significantly more frequent in the frontal and temporal regions in TA group. To our knowledge, there is no study indicating regrowing hair among the trichoscopic findings of TA due to the confusion between regrowing hair and vellus hair, especially in light hair color. Additionally, regrowing hair finding in the frontotemporal region may be usefull in the differential diagnosis of TA from FAGA and MAGA. Broken hair, breakage of hair shafts at different levels, mainly observed in trichotillomania (TTM) (6), and also in patients with TA (6,12). Broken hair was reported 68% of TA patients (11), but not in androgenetic alopecia (18). The mean number of broken hair finding in the frontal region was 0.46 ± 0.84 in TA patients, while no broken hair was observed in FAGA, MAGA, and TE groups. Broken hair finding in the frontal region may be used to distinguish TA from FAGA, MAGA, and TE. Lonely hair, a single terminal follicle on the forehead, indicates the location of the original hairline in patients with receding hairlines (19) and a asign of frontal fibrosing alopecia (18). In our study, lonely hair finding was significantly more common in the MAGA (88.2%) patients, which is not considered in the literature. This may be due to the few number of trichoscopic studies on the lonely hair. Lonely hair may be observed in MAGA due to receding of the frontal hairline. Peripilar sign, a brown depressed halo surrounding the follicle related to perifollicular inflammation, is observed especially in patients with early-stage androgenetic alopecia (6). The studies reported higher rates of peripilar sign in FAGA and MAGA patients (8,10), and was significantly more common in FAGA than in chronic TE (9). In the present study, peripilar sign in the frontal region was similar among all patients, and was significantly higher in the vertex in the MAGA (23.5%) group. Peripilar sign may distinguish MAGA from TA and TE in the vertex region. The absence of follicular opening has been reported in MAGA and FAGA, especially in scarring alopecia (3,10). Absence of follicular openings was present in 76% of TA patients and was significantly higher in turban users for >10 years than in turban users for <10 years (11). In our study, absence of follicular opening in the frontal region was significantly higher in the TA (75.0%) group, and was significantly higher in FAGA (56.7%) group in the vertex. The absence of follicular opening may be contributing to the differential diagnosis in favor of TA in the frontal region and in favor of FAGA in the vertex. White patches are irregular white areas devoid of hair and follicular openings, commonly observed in scarring alopecias corresponding dermal fibrosis (6). TA, typically a non-scarring alopecia, may progress to scarring triggered by prolonged mechanical trauma (15). In the present study white patch finding was significantly higher in TA patients (35.7%) in frontal and temporal regions. To our knowledge, white patch in TA has not been defined in systematic reviews and studies, but Tosti has mentioned white patches in TA patients (6,11,14). Progressive stages of TA may be accompained with white patches. White patch finding may distinguish TA from other types of alopecias. Black dot in follicular opening, hair breaking just before reaching the scalp, (6) is observed in TA patients (11,18,20). In our study, the mean number of black dot finding in the frontal region was significantly highest in the TA (0.61 ± 0.92) group. Regarding temporal region, black dots were not observed in any of the FAGA, MAGA, and TE patients, while 0.21 ± 0.57 black dots were observed in TA patients. The average number of black dot finding in the frontal and temporal regions can distinguish TA from FAGA, MAGA, and TE. However white dot and pinpoint white dot were previously referred to as the same trichoscopic entity, currently they were evaluated as distinct antities. White dot is a white fibrotic area corresponding to the loss of follicular ostia (3), pinpoint white dot is a characteristic finding of dark-colored scalp corresponding to sweat gland openings with a regular distribution (6). White dot finding was reported to be more common in males than in females and was significantly more frequent in (47.8%) in male AGA patients with severe disease (7). In our study the mean number of white dot finding in the vertex was significantly higher in FAGA (1.37 ± 2.34) patients and the mean number of white dot finding in the temporal region was significantly higher in the TA (1.18 ± 1.09) patients. The mean number of white dot finding was higher in FAGA in the vertex and in TA in the temporal region may contribute to differential diagnosis. White spot-related terminology confusion may be due to the lack of clear distinction of white dots and pinpoint white dots. Yellow dots are follicular openings filled with sebum and degenerated keratinocytes, represent severe miniaturization in MAGA and FAGA (6). Yellow dots were detected in 21.1% of TE, 30.5% of AGA, and 68% of TA patients (10,11,20). Also the total number of yellow dots was found to be significantly higher in the frontal region in FAGA patients, and suggested to be the most important trichoscopic finding capable of distinguish FAGA from chronic TE (9). Since the average number of yellow dots were similar in the frontal, vertex, and temporal regions in the FAGA, MAGA, TA, and TE patients in our study, the average number of yellow dot finding may not be useful for differential diagnosis between FAGA, MAGA, TA, and TE patients. Discrepancy of our results and the literature may be due to the subjectivity of trichoscopic evaluation and the lack of standardization of yellow dot finding. Hair powder is the appearance of hair residues scattered on the scalp secondary to damaged hair shafts due to mechanical trauma (17). In TTM, hair powder can be seen due to the patient's compulsive hair pulling (6, 21). Particle residues of various colors may not be distinguished from hair powder (3). In the present study, 17.9% of patients diagnosed with TA in the frontal region were presented with hair powder. To our knowledge, hair powder has not been shown to be among the trichoscopic findings of TA. As well as TTM, hair powder may be seen in TA due to mechanical trauma to the hair. Evaluation of trichoscopic findings in multiple areas (frontal, vertex, temporal and occipital) of the scalp rather than in a single area, the identification of trichoscopic differences between female and male patients with AGA, the comparison of more than two types of alopecia regarding trichoscopic findings, numerical calculation of trichoscopic findings for each region, and the discussion of trichoscopic findings leading conceptual confusion are among the superior aspects of our work. The study's limitations include the relatively small number and lack of diversity of patients due to its being conducted at a single center. In conclusion, trichoscopy is a useful technique in the differential diagnosis of alopecias. Since the number, occurrence rate, and location of trichoscopic findings are important, trichoscopic evaluation should include all areas of the scalp. Our study may provide more efficient and accurate use of trichoscopy in challenging cases of non-cicatricial alopecias. Further studies are needed to standardize trichoscopic findings and eliminate conceptual confusion for effective diagnosis of alopecias. Declarations Funding sources : None Conflicts of Interest : The authors declare that there are no conflicts of interest regarding the publication of this manuscript. Ethical approval : Clinical Research Ethics Committee of Süleyman Demirel University Faculty of Medicine (SDÜTF) with decision no. 374 dated 29.12.2023 Patient Consent on File: Signed informed consent forms were obtained from all participants in the study. 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Rudnicka L, Rakowska A, Kerzeja M, Olszewska M. Hair shafts in trichoscopy: clues for diagnosis of hair and scalp diseases. Dermatol Clin. 2013;31(4):695-708, x. Blume‐Peytavi U, Blumeyer A, Tosti A, Finner A, Marmol V, Trakatelli M, et al. S1 guideline for diagnostic evaluation in androgenetic alopecia in men, women and adolescents. British Journal of Dermatology. 2011;164(1):5-15. Afifi L, Oparaugo NC, Hogeling M. Review of traction alopecia in the pediatric patient: Diagnosis, prevention, and management. Pediatric Dermatology. 2021;38:42-8. De Souza B, Tovar-Garza A, Uwakwe LN, McMichael A. Bitemporal Scalp Hair Loss: Differential Diagnosis of Nonscarring and Scarring Conditions. J Clin Aesthet Dermatol. 2021;14(2):26-33. Al-Dhubaibi MS, Alsenaid A, Alhetheli G, Abd Elneam AI. Trichoscopy pattern in alopecia areata: A systematic review and meta-analysis. Skin Res Technol. 2023;29(6):e13378. Rakowska A, Slowinska M, OLSzEWSKA M, RuDNICKA L. New trichoscopy findings in trichotillomania: flame hairs, V-sign, hook hairs, hair powder, tulip hairs. Acta Derm Venereol. 2014;94(3):303-6. Khutsishvili N, Rudnicka L, Ovcharenko Y, Starace M, Buchukuri I, Pataraia S, et al. Trichoscopy - a valuable tool for identifying conditions mimicking androgenetic alopecia. Int J Dermatol. 2024;63(1):23-31. Mathur M, Acharya P. Trichoscopy of primary cicatricial alopecias: an updated review. J Eur Acad Dermatol Venereol. 2020;34(3):473-84. Khare S, Behera B, Ding DD, Lallas A, Chauhan P, Enechukwu NA, et al. Dermoscopy of Hair and Scalp Disorders (Trichoscopy) in Skin of Color - A Systematic Review by the International Dermoscopy Society "Imaging in Skin of Color" Task Force. Dermatol Pract Concept. 2023;13(4 s1). Pirmez R. The dermatoscope in the hair clinic: Trichoscopy of scarring and nonscarring alopecia. Journal of the American Academy of Dermatology. 2023;89(2, Supplement):S9-S15. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 09 Apr, 2026 Reviewers agreed at journal 07 Apr, 2026 Reviewers invited by journal 01 Apr, 2026 Editor assigned by journal 16 Feb, 2026 Submission checks completed at journal 16 Feb, 2026 First submitted to journal 14 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8880023","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":617343311,"identity":"4f4cb59d-a5d0-460b-bb37-9120964817a2","order_by":0,"name":"Muhammed Ali Gökkaya","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1ElEQVRIiWNgGAWjYDACHjYQacHDD6ISCojXIsEj2QDSYkCCFgaDAyCaGC3yPsfSpG7USMgYn1+d+OGBAYM8v9gB/FoMz7Ydk845JsFjduPtZgmgwwxnzk4goKWfvU06hw2k5ewGkJYEg9tEafknwWM84+zmH0RpkecFOiy3TYLHgL93G3G2GPAcS7bO7ZPgkbjBu80iwUCCsF/ke9IMb+d8s7Hn7z+7+eaPCht5fmlCthxgYJEAsyTAKiXwKwfb0sDA/AHM4j9AWPUoGAWjYBSMTAAA6A0/iReor7AAAAAASUVORK5CYII=","orcid":"","institution":"Süleyman Demirel University","correspondingAuthor":true,"prefix":"","firstName":"Muhammed","middleName":"Ali","lastName":"Gökkaya","suffix":""},{"id":617343313,"identity":"cc278e89-9503-461e-9697-411aad5ba2c5","order_by":1,"name":"İjlal Erturan","email":"","orcid":"","institution":"Süleyman Demirel University","correspondingAuthor":false,"prefix":"","firstName":"İjlal","middleName":"","lastName":"Erturan","suffix":""},{"id":617343314,"identity":"9aced20f-6765-4942-b544-aa84d2830298","order_by":2,"name":"Mehmet Yıldırım","email":"","orcid":"","institution":"Süleyman Demirel University","correspondingAuthor":false,"prefix":"","firstName":"Mehmet","middleName":"","lastName":"Yıldırım","suffix":""},{"id":617343315,"identity":"42b3bf7b-23ad-4148-9161-b1d0d8e4db61","order_by":3,"name":"Hikmet Orhan","email":"","orcid":"","institution":"Süleyman Demirel University","correspondingAuthor":false,"prefix":"","firstName":"Hikmet","middleName":"","lastName":"Orhan","suffix":""}],"badges":[],"createdAt":"2026-02-14 12:53:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8880023/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8880023/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106311705,"identity":"8ef7af29-e10e-4b0d-bb6b-8d4f35b895a3","added_by":"auto","created_at":"2026-04-07 10:33:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1126033,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8880023/v1/bcbeb633-9ea9-4818-bbfb-faf8330d4902.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Is Trichoscopy A Reliable Method For Differantiation Of Frontal Non-Scarring Alopecias?","fulltext":[{"header":"Capsule summary","content":"\u003cul\u003e\n \u003cli\u003e(\u003cstrong\u003eFirst bullet\u003c/strong\u003e) Trichoscopy is used for diagnosing and following-up hair diseases; it is a rapid and non-invasive technique but needs to be standardized for improving its accuracy and consistency.\u003c/li\u003e\n \u003cli\u003e(\u003cstrong\u003eSecond bullet\u003c/strong\u003e) Since the number, occurrence rate, and location of trichoscopic findings are important, trichoscopic evaluation should include all areas of the scalp.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"INTRODUCTION","content":"\u003cp\u003eAlopecia is a common condition that often leads to psychological stress. Physicians may have difficulties in a specific diagnosis (1). Scarring and non-scarring alopecia have been identified. Non-scarring alopecia is a more common condition, while scarring alopecia is rarer and is characterized by permanent hair loss (2).\u003c/p\u003e \u003cp\u003eDespite trichoscopy, also known as hair and scalp dermatoscopy, is a non-invasive, easy and well accepted method in diagnosis, treatment monitoring and following up alopecias (3\u0026ndash;6), is an underdeveloped technique needs to be standardized and be improved for its accuracy and consistency. Difficulties may arise due to non-standardized terminology and to differences in skin phototype and hair color. The aim of the present study is to be able to differantiate traction alopecia (TA), female pattern hair loss (FAGA), male pattern hair loss (MAGA), telogen effluvium (TE) with trichoscopic findings and to contribute to trichoscopic standardization.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003eBetween December 2023-May 2024, 107 patients aged 18\u0026ndash;65 years with frontal non-scarring alopecia were enrolled to the study. The study was approved by the Clinical Research Ethics Committee of S\u0026uuml;leyman Demirel University Faculty of Medicine, and written informed consent were obtained from the all partipicants. Patients with uncontrolled systemic or chronic dermatologic diseases were excluded. Diagnoses were based on clinical findings and/or scalp biopsy. Demographic and clinical data, skin phototype, and hair styling practices were recorded.\u003c/p\u003e \u003cp\u003eStandardized clinical photographs and trichoscopic images of the frontal, vertex, temporal, and occipital scalp regions were obtained using a FotoFinder Medicam 1000 videodermatoscope. Four trichoscopic images at 20x magnification were recorded by the same physician for each region. Average number of certain trichoscopic findings (single follicular unit, broken hair, black dot, vellus hair, thin hair, white dot, yellow dot) were calculated (each area at 20x magnification was 0.9 mm\u0026sup2;) for each region.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eData were analyzed with SPSS version 29.0. Descriptive statistics were presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation. Categorical variables were given as numbers and percentages. Comparisons of categorical data were performed by the Pearson chi-square test. The normality of continuous variables was analysed with Kolmogorov-Smirnov and Shapiro-Wilk test. The Bonferroni correction test was used for pairwise comparisons of the four groups and a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eThe study included a total of 100 patients diagnosed with 30 FAGA, 17 MAGA, 28 TA, 25 TE. The demographic and clinical features of the patient group were presented in table 1. The mean number of single follicular unit finding in the FAGA (10.70\u0026thinsp;\u0026plusmn;\u0026thinsp;6.59), MAGA (13.12\u0026thinsp;\u0026plusmn;\u0026thinsp;9.05), and TA (9.21\u0026thinsp;\u0026plusmn;\u0026thinsp;3.99) groups were significantly higher in the frontal region (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and was significantly higher in the vertex in the FAGA (8.30\u0026thinsp;\u0026plusmn;\u0026thinsp;5.68) and MAGA (8.65\u0026thinsp;\u0026plusmn;\u0026thinsp;9.61) groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The mean number of vellus hair finding in the frontal region was significantly higher in the MAGA (16.18\u0026thinsp;\u0026plusmn;\u0026thinsp;13.12) group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), was significantly higher in the vertex in the FAGA (2.33\u0026thinsp;\u0026plusmn;\u0026thinsp;3.04) and MAGA (7.53\u0026thinsp;\u0026plusmn;\u0026thinsp;8.21) groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The hair diameter diversity in the frontal region was significantly more common in the FAGA (90%), MAGA (100%), and TA (89.3%) groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and was significantly more common in the FAGA (86.7%) and MAGA (76.5%) groups in the vertex (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and was significantly more common in the TA (71.4%) group in the temporal region (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Vascular pattern characteristics were similar among the groups. Comparison of groups in terms of trichoscopic findings were shown in Table\u0026nbsp;2 and Table\u0026nbsp;3.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic Features of Patients According to Diagnoses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFAGA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMAGA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFFA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTTM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (28,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (15,9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (26,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25 (23,4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (2,8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (3,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFemale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\varvec{X}}\\pm\\:\\varvec{S}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38,77\u0026thinsp;\u0026plusmn;\u0026thinsp;14,46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32,29\u0026thinsp;\u0026plusmn;\u0026thinsp;12,12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35,61\u0026thinsp;\u0026plusmn;\u0026thinsp;2,41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31,00\u0026thinsp;\u0026plusmn;\u0026thinsp;11,19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37,6\u0026thinsp;\u0026plusmn;\u0026thinsp;12,74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e26,7\u0026thinsp;\u0026plusmn;\u0026thinsp;10,68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c10\" namest=\"c9\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of disease\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\varvec{X}}\\pm\\:\\varvec{S}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7,38\u0026thinsp;\u0026plusmn;\u0026thinsp;6,75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6,26\u0026thinsp;\u0026plusmn;\u0026thinsp;4,78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5,71\u0026thinsp;\u0026plusmn;\u0026thinsp;5,08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1,95\u0026thinsp;\u0026plusmn;\u0026thinsp;2,17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2,66\u0026thinsp;\u0026plusmn;\u0026thinsp;0,57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e3,25\u0026thinsp;\u0026plusmn;\u0026thinsp;0,95\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\varvec{X}}\\pm\\:\\varvec{S}\\)\u003c/span\u003e\u003c/span\u003e: Mean and Standard Deviation, FAGA: Female pattern hair loss, MAGA: Male pattern hair loss, TA: Traction alopecia, TE: Telogen effluvium, FFA: Frontal fibrosing alopecia, TTM: Trichotillomania\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Diagnostic Groups in Terms of Trichoscopic Findings\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrichoscopic Findings n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFAGA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMAGA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegrowing Hair Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003csub\u003ea\u003c/sub\u003e (33,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003csub\u003ea\u003c/sub\u003e (23,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003csub\u003eb\u003c/sub\u003e (67,9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23\u003csub\u003ec\u003c/sub\u003e (92,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegrowing Hair Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003csub\u003ea\u003c/sub\u003e (20,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003csub\u003ea\u003c/sub\u003e (17,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003csub\u003ea\u003c/sub\u003e (14,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15\u003csub\u003eb\u003c/sub\u003e (60,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegrowing Hair Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003csub\u003ea, b\u003c/sub\u003e (23,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003csub\u003eb\u003c/sub\u003e (11,8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u003csub\u003ea\u003c/sub\u003e (46,4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20\u003csub\u003ec\u003c/sub\u003e (80,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHair Powder Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003csub\u003ea\u003c/sub\u003e (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003csub\u003ea, b\u003c/sub\u003e (5,9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003csub\u003eb\u003c/sub\u003e (17,9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003csub\u003ea\u003c/sub\u003e (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,015\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHair Powder Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e≌1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHair Powder Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (7,1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHair Diameter Diversity Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27\u003csub\u003ea\u003c/sub\u003e (90,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003csub\u003ea\u003c/sub\u003e (100,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u003csub\u003ea\u003c/sub\u003e (89,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9\u003csub\u003eb\u003c/sub\u003e (36,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHair Diameter Diversity Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26\u003csub\u003ea\u003c/sub\u003e (86,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003csub\u003ea\u003c/sub\u003e (76,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003csub\u003eb\u003c/sub\u003e (3,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003csub\u003ec\u003c/sub\u003e (24,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHair Diameter Diversity Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003csub\u003ea, b\u003c/sub\u003e (60,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003csub\u003eb, c\u003c/sub\u003e (35,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20\u003csub\u003ea\u003c/sub\u003e (71,4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003csub\u003ec\u003c/sub\u003e (28,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLonely Hair\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003csub\u003ea\u003c/sub\u003e (3,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003csub\u003eb\u003c/sub\u003e (88,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003csub\u003ea\u003c/sub\u003e (7,1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003csub\u003ea\u003c/sub\u003e (8,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFocal Atrichia Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (83,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (94,1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (89,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 (68,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFocal Atrichia Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003csub\u003ea\u003c/sub\u003e (66,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003csub\u003ea, b\u003c/sub\u003e (70,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003csub\u003ec\u003c/sub\u003e (21,4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003csub\u003eb, c\u003c/sub\u003e (40,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFocal Atrichia Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (66,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (41,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (64,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (48,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0,230\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAbsence of Follicular Openings Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003csub\u003ea\u003c/sub\u003e (46,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003csub\u003eb\u003c/sub\u003e (88,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21\u003csub\u003eb\u003c/sub\u003e (75,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003csub\u003ea\u003c/sub\u003e (32,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAbsence of Follicular Openings Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17\u003csub\u003ea\u003c/sub\u003e (56,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003csub\u003ea\u003c/sub\u003e (64,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003csub\u003eb\u003c/sub\u003e (10,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003csub\u003eb\u003c/sub\u003e (8,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAbsence of Follicular Openings Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003csub\u003ea\u003c/sub\u003e (33,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003csub\u003ea\u003c/sub\u003e (29,4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u003csub\u003eb\u003c/sub\u003e (64,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003csub\u003ea\u003c/sub\u003e (20,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePeripilar Sign Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (23,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (41,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (17,9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (16,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0,232\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePeripilar Sign Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003csub\u003ea, b\u003c/sub\u003e (6,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003csub\u003eb\u003c/sub\u003e (23,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003csub\u003ea\u003c/sub\u003e (3,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003csub\u003ea\u003c/sub\u003e (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,023\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePeripilar SignTemporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (16,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (23,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (7,1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0,179\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHoneycomb Pigment Pattern Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (56,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (64,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (53,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (32,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0,148\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHoneycomb Pigment Pattern Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003csub\u003ea, b\u003c/sub\u003e (33,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003csub\u003eb\u003c/sub\u003e (52,9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003csub\u003ea\u003c/sub\u003e (14,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003csub\u003ea\u003c/sub\u003e (16,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,017\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHoneycomb Pigment Pattern Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (20,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (41,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (39,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (32,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0,344\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eİnterfolicular Scale Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003csub\u003ea\u003c/sub\u003e (13,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003csub\u003ea\u003c/sub\u003e (11,8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003csub\u003eb\u003c/sub\u003e (39,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11\u003csub\u003eb\u003c/sub\u003e (44,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,016\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eİnterfolicular Scale Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (23,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (11,8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (42,9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (32,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0,130\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhite Patch Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003csub\u003ea\u003c/sub\u003e (3,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003csub\u003ea\u003c/sub\u003e (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003csub\u003eb\u003c/sub\u003e (35,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003csub\u003ea\u003c/sub\u003e (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhite Patch Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (3,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (3,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (4,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0,694\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhite Patch Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003csub\u003ea\u003c/sub\u003e (3,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003csub\u003ea\u003c/sub\u003e (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003csub\u003eb\u003c/sub\u003e (35,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003csub\u003ea\u003c/sub\u003e (0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003csup\u003e*\u003c/sup\u003ePearson Chi-square test: There is no statistically significant difference between groups containing the same letter (a, b, c) (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). FAGA: Female pattern hair loss, MAGA: Male pattern hair loss, TA: Traction alopecia, TE: Telogen effluvium\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\u003c/br\u003e\n\u003cp\u003e \u003cb\u003eTable\u0026nbsp;3.\u003c/b\u003e Comparison of Diagnostic Groups with Trichoscopic Findings (Mean and Standard Deviation)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrichoscopic Findings\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFAGA\u003c/p\u003e \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\varvec{X}}\\pm\\:\\varvec{S}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMAGA\u003c/p\u003e \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\varvec{X}}\\pm\\:\\varvec{S}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTA\u003c/p\u003e \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\varvec{X}}\\pm\\:\\varvec{S}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTE\u003c/p\u003e \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\varvec{X}}\\pm\\:\\varvec{S}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSingle Follicular Unit Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10,70\u0026thinsp;\u0026plusmn;\u0026thinsp;6,59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13,12\u0026thinsp;\u0026plusmn;\u0026thinsp;9,05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9,21\u0026thinsp;\u0026plusmn;\u0026thinsp;3,99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4,16\u0026thinsp;\u0026plusmn;\u0026thinsp;2,88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSingle Follicular Unit Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8,30\u0026thinsp;\u0026plusmn;\u0026thinsp;5,68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8,65\u0026thinsp;\u0026plusmn;\u0026thinsp;9,61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,18\u0026thinsp;\u0026plusmn;\u0026thinsp;2,80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3,60\u0026thinsp;\u0026plusmn;\u0026thinsp;2,42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSingle Follicular Unit Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7,80\u0026thinsp;\u0026plusmn;\u0026thinsp;5,36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6,00\u0026thinsp;\u0026plusmn;\u0026thinsp;7,22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7,18\u0026thinsp;\u0026plusmn;\u0026thinsp;4,10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4,80\u0026thinsp;\u0026plusmn;\u0026thinsp;4,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,051\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBroken Hair Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,46\u0026thinsp;\u0026plusmn;\u0026thinsp;0,84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBroken Hair Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e≌1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBroken Hair Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e≌1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBlack Dot Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,07\u0026thinsp;\u0026plusmn;\u0026thinsp;0,25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,24\u0026thinsp;\u0026plusmn;\u0026thinsp;0,66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,61\u0026thinsp;\u0026plusmn;\u0026thinsp;0,92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,08\u0026thinsp;\u0026plusmn;\u0026thinsp;0,28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,007\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBlack Dot Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e≌1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBlack Dot Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,21\u0026thinsp;\u0026plusmn;\u0026thinsp;0,57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,00\u0026thinsp;\u0026plusmn;\u0026thinsp;0,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,014\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVellus Hair Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4,63\u0026thinsp;\u0026plusmn;\u0026thinsp;5,92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16,18\u0026thinsp;\u0026plusmn;\u0026thinsp;13,12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6,11\u0026thinsp;\u0026plusmn;\u0026thinsp;4,55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1,16\u0026thinsp;\u0026plusmn;\u0026thinsp;2,49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVellus Hair Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,33\u0026thinsp;\u0026plusmn;\u0026thinsp;3,04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7,53\u0026thinsp;\u0026plusmn;\u0026thinsp;8,21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,21\u0026thinsp;\u0026plusmn;\u0026thinsp;0,63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,16\u0026thinsp;\u0026plusmn;\u0026thinsp;0,55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVellus Hair Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,10\u0026thinsp;\u0026plusmn;\u0026thinsp;3,06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6,00\u0026thinsp;\u0026plusmn;\u0026thinsp;4,91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4,11\u0026thinsp;\u0026plusmn;\u0026thinsp;3,35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,20\u0026thinsp;\u0026plusmn;\u0026thinsp;1,00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThin Hair Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14,30\u0026thinsp;\u0026plusmn;\u0026thinsp;7,55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16,35\u0026thinsp;\u0026plusmn;\u0026thinsp;8,35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12,07\u0026thinsp;\u0026plusmn;\u0026thinsp;5,08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5,84\u0026thinsp;\u0026plusmn;\u0026thinsp;4,42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThin Hair Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12,23\u0026thinsp;\u0026plusmn;\u0026thinsp;5,36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13,00\u0026thinsp;\u0026plusmn;\u0026thinsp;9,27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4,32\u0026thinsp;\u0026plusmn;\u0026thinsp;2,80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4,92\u0026thinsp;\u0026plusmn;\u0026thinsp;3,95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThin Hair Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10,00\u0026thinsp;\u0026plusmn;\u0026thinsp;5,53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6,88\u0026thinsp;\u0026plusmn;\u0026thinsp;4,48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9,75\u0026thinsp;\u0026plusmn;\u0026thinsp;5,32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5,56\u0026thinsp;\u0026plusmn;\u0026thinsp;4,07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhite Spot Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,27\u0026thinsp;\u0026plusmn;\u0026thinsp;1,87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,12\u0026thinsp;\u0026plusmn;\u0026thinsp;1,36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,71\u0026thinsp;\u0026plusmn;\u0026thinsp;1,24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,92\u0026thinsp;\u0026plusmn;\u0026thinsp;1,63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,060\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhite Spot Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,37\u0026thinsp;\u0026plusmn;\u0026thinsp;2,34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,76\u0026thinsp;\u0026plusmn;\u0026thinsp;1,03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,07\u0026thinsp;\u0026plusmn;\u0026thinsp;0,26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,32\u0026thinsp;\u0026plusmn;\u0026thinsp;0,99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhite Spot Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,87\u0026thinsp;\u0026plusmn;\u0026thinsp;1,47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,29\u0026thinsp;\u0026plusmn;\u0026thinsp;0,68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,18\u0026thinsp;\u0026plusmn;\u0026thinsp;1,09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,44\u0026thinsp;\u0026plusmn;\u0026thinsp;1,04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0,013\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYellow Spot Frontal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,10\u0026thinsp;\u0026plusmn;\u0026thinsp;1,52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,88\u0026thinsp;\u0026plusmn;\u0026thinsp;1,32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,25\u0026thinsp;\u0026plusmn;\u0026thinsp;1,82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,88\u0026thinsp;\u0026plusmn;\u0026thinsp;1,05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,946\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYellow Spot Vertex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,70\u0026thinsp;\u0026plusmn;\u0026thinsp;1,18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,76\u0026thinsp;\u0026plusmn;\u0026thinsp;1,30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,29\u0026thinsp;\u0026plusmn;\u0026thinsp;0,66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,24\u0026thinsp;\u0026plusmn;\u0026thinsp;0,72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,146\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYellow Spot Temporal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0,50\u0026thinsp;\u0026plusmn;\u0026thinsp;1,11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0,29\u0026thinsp;\u0026plusmn;\u0026thinsp;0,69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,71\u0026thinsp;\u0026plusmn;\u0026thinsp;1,36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0,08\u0026thinsp;\u0026plusmn;\u0026thinsp;0,40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0,123\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003e*\u003c/sup\u003eKruskal-Wallis Testi, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{\\varvec{X}}\\pm\\:\\varvec{S}\\)\u003c/span\u003e\u003c/span\u003e: Mean and Standard Deviation, FAGA: Female pattern hair loss, MAGA: Male pattern hair loss, TA: Traction alopecia, TE: Telogen effluvium\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eTrichoscopy is becoming an increasingly important technique in the differential diagnosis of cicatricial and non-cicatricial alopecias. Trichoscopic differential diagnoses of patients with non-cicatricial hair loss in the frontal area will be discussed here. All patients\u0026rsquo; included in the study, mean age results were consistent with the literat\u0026uuml;re (7\u0026ndash;11).\u003c/p\u003e \u003cp\u003eOn a healthy scalp, mean number of 2\u0026ndash;4 terminal hair, emerge from a single follicular unit (9). Increase in the number of single hair follicular unit is considered a sign of early-stage androgenetic alopecia and is one of the common findings of TA (5). The rate of single follicular unit finding in the frontal region was reported to be significantly higher in FAGA group (65%) compared to TE group (39%) and healthy controls (27%) (9). While the mean number of single hair follicular unit finding in the frontal region was significantly higher in the FAGA (10.70\u0026thinsp;\u0026plusmn;\u0026thinsp;6.59), MAGA (13.12\u0026thinsp;\u0026plusmn;\u0026thinsp;9.05) and TA groups (9.21\u0026thinsp;\u0026plusmn;\u0026thinsp;3.99), the mean number of single hair follicular units in the vertex was significantly higher in the FAGA (8.30\u0026thinsp;\u0026plusmn;\u0026thinsp;5.68) and MAGA (8.65\u0026thinsp;\u0026plusmn;\u0026thinsp;9.61) groups in the present study. Since TA usually involves the frontotemporal region, the mean number of single follicular unit finding in the vertex is expected to be lower than that in the frontal region. The mean number of single hair follicular unit finding may support FAGA, MAGA, and TA in the frontal region, FAGA and MAGA in the vertex.\u003c/p\u003e \u003cp\u003eVellus are shorter (\u0026lt;3mm), thinner (\u0026lt;0.003mm), blunt-ended, hypopigmented, and wavy shaped hairs without medulla an indicator of severe miniaturization of androgenetic alopecia (12). Numerous vellus hairs might be seen in TA since they are too short to undergo mechanical trauma (6, 13). In a study comparing groups that had worn turbans for \u0026gt;10 years and \u0026lt;10 years, vellus hair was detected in all patients diagnosed with TA (11), and in another study vellus hair was detected in 44% of AGA patients (10). In the present study, the mean number of vellus hair finding was significantly higher in the frontal and temporal regions in the MAGA, FAGA, and TA groups, also vellus hair finding was significantly higher in the FAGA and MAGA groups in the vertex. Mean number of vellus hairs may distuinguish FAGA and TA from TE in the frontal and temporal regions, also FAGA from TA in the vertex. Additionally, the mean number of vellus hair finding in the frontal and temporal regions were significantly higher in MAGA than in FAGA groups indicating more prevalent miniaturization in men than in women. To our knowledge, there is no study comparing the vellus hair finding in FAGA and MAGA numerically.\u003c/p\u003e \u003cp\u003eThe hair diameter diversity or anisotrichosis refers to the variability in hair schaft diameter. (6). There is no consensus on whether hair diameter variation of more than 20% in male and female patients (7, 8, 10) or more than 20% in males and more than 10% in females should be considered as diagnostic criteria for AGA (12). The hair diameter diversity was significantly higher in the FAGA (90%), MAGA (100%) and TA (89.3%) patients in the frontal region, higher in the TA (71.4) and FAGA (60%) patients in the temporal region, higher in the FAGA (86.7%) and MAGA (76.5%) patients in the vertex. The evaluation of regional hair diameter diversity may be useful in differential diagnosis of alopecias. TA is generally observed in the frontotemporal scalp and hair shaft diameter diversity is one of the primary trichoscopic findings (11,14). TA may occur due to hair styles causing prolonged tension of the hair (14, 15). Turban use can cause traction (14) and significant increase in trichoscopic findings belonging to TA as the duration of turban use increases (11). In the present study, the habit of tight hair styling was significantly more common in the TA group.\u003c/p\u003e \u003cp\u003eRegrowing hair refers to short hair growing upright, thinner and tapered at the distal end (3,9,12,16). Regrowing hair is the most common but not specific trichoscopic finding of TE (3,5,17,18) and is suggested to be an important indicator for chronic TE (9). Consistent with the literature, regrowing hair finding was most frequently observed in the TE group in all three regions and was significantly more frequent in the frontal and temporal regions in TA group. To our knowledge, there is no study indicating regrowing hair among the trichoscopic findings of TA due to the confusion between regrowing hair and vellus hair, especially in light hair color. Additionally, regrowing hair finding in the frontotemporal region may be usefull in the differential diagnosis of TA from FAGA and MAGA.\u003c/p\u003e \u003cp\u003eBroken hair, breakage of hair shafts at different levels, mainly observed in trichotillomania (TTM) (6), and also in patients with TA (6,12). Broken hair was reported 68% of TA patients (11), but not in androgenetic alopecia (18). The mean number of broken hair finding in the frontal region was 0.46\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84 in TA patients, while no broken hair was observed in FAGA, MAGA, and TE groups. Broken hair finding in the frontal region may be used to distinguish TA from FAGA, MAGA, and TE.\u003c/p\u003e \u003cp\u003eLonely hair, a single terminal follicle on the forehead, indicates the location of the original hairline in patients with receding hairlines (19) and a asign of frontal fibrosing alopecia (18). In our study, lonely hair finding was significantly more common in the MAGA (88.2%) patients, which is not considered in the literature. This may be due to the few number of trichoscopic studies on the lonely hair. Lonely hair may be observed in MAGA due to receding of the frontal hairline.\u003c/p\u003e \u003cp\u003ePeripilar sign, a brown depressed halo surrounding the follicle related to perifollicular inflammation, is observed especially in patients with early-stage androgenetic alopecia (6). The studies reported higher rates of peripilar sign in FAGA and MAGA patients (8,10), and was significantly more common in FAGA than in chronic TE (9). In the present study, peripilar sign in the frontal region was similar among all patients, and was significantly higher in the vertex in the MAGA (23.5%) group. Peripilar sign may distinguish MAGA from TA and TE in the vertex region.\u003c/p\u003e \u003cp\u003eThe absence of follicular opening has been reported in MAGA and FAGA, especially in scarring alopecia (3,10). Absence of follicular openings was present in 76% of TA patients and was significantly higher in turban users for \u0026gt;10 years than in turban users for \u0026lt;10 years (11). In our study, absence of follicular opening in the frontal region was significantly higher in the TA (75.0%) group, and was significantly higher in FAGA (56.7%) group in the vertex. The absence of follicular opening may be contributing to the differential diagnosis in favor of TA in the frontal region and in favor of FAGA in the vertex.\u003c/p\u003e \u003cp\u003eWhite patches are irregular white areas devoid of hair and follicular openings, commonly observed in scarring alopecias corresponding dermal fibrosis (6). TA, typically a non-scarring alopecia, may progress to scarring triggered by prolonged mechanical trauma (15). In the present study white patch finding was significantly higher in TA patients (35.7%) in frontal and temporal regions. To our knowledge, white patch in TA has not been defined in systematic reviews and studies, but Tosti has mentioned white patches in TA patients (6,11,14). Progressive stages of TA may be accompained with white patches. White patch finding may distinguish TA from other types of alopecias.\u003c/p\u003e \u003cp\u003eBlack dot in follicular opening, hair breaking just before reaching the scalp, (6) is observed in TA patients (11,18,20). In our study, the mean number of black dot finding in the frontal region was significantly highest in the TA (0.61\u0026thinsp;\u0026plusmn;\u0026thinsp;0.92) group. Regarding temporal region, black dots were not observed in any of the FAGA, MAGA, and TE patients, while 0.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57 black dots were observed in TA patients. The average number of black dot finding in the frontal and temporal regions can distinguish TA from FAGA, MAGA, and TE.\u003c/p\u003e \u003cp\u003eHowever white dot and pinpoint white dot were previously referred to as the same trichoscopic entity, currently they were evaluated as distinct antities. White dot is a white fibrotic area corresponding to the loss of follicular ostia (3), pinpoint white dot is a characteristic finding of dark-colored scalp corresponding to sweat gland openings with a regular distribution (6). White dot finding was reported to be more common in males than in females and was significantly more frequent in (47.8%) in male AGA patients with severe disease (7). In our study the mean number of white dot finding in the vertex was significantly higher in FAGA (1.37\u0026thinsp;\u0026plusmn;\u0026thinsp;2.34) patients and the mean number of white dot finding in the temporal region was significantly higher in the TA (1.18\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09) patients. The mean number of white dot finding was higher in FAGA in the vertex and in TA in the temporal region may contribute to differential diagnosis. White spot-related terminology confusion may be due to the lack of clear distinction of white dots and pinpoint white dots.\u003c/p\u003e \u003cp\u003eYellow dots are follicular openings filled with sebum and degenerated keratinocytes, represent severe miniaturization in MAGA and FAGA (6). Yellow dots were detected in 21.1% of TE, 30.5% of AGA, and 68% of TA patients (10,11,20). Also the total number of yellow dots was found to be significantly higher in the frontal region in FAGA patients, and suggested to be the most important trichoscopic finding capable of distinguish FAGA from chronic TE (9). Since the average number of yellow dots were similar in the frontal, vertex, and temporal regions in the FAGA, MAGA, TA, and TE patients in our study, the average number of yellow dot finding may not be useful for differential diagnosis between FAGA, MAGA, TA, and TE patients. Discrepancy of our results and the literature may be due to the subjectivity of trichoscopic evaluation and the lack of standardization of yellow dot finding.\u003c/p\u003e \u003cp\u003eHair powder is the appearance of hair residues scattered on the scalp secondary to damaged hair shafts due to mechanical trauma (17). In TTM, hair powder can be seen due to the patient's compulsive hair pulling (6, 21). Particle residues of various colors may not be distinguished from hair powder (3). In the present study, 17.9% of patients diagnosed with TA in the frontal region were presented with hair powder. To our knowledge, hair powder has not been shown to be among the trichoscopic findings of TA. As well as TTM, hair powder may be seen in TA due to mechanical trauma to the hair.\u003c/p\u003e \u003cp\u003eEvaluation of trichoscopic findings in multiple areas (frontal, vertex, temporal and occipital) of the scalp rather than in a single area, the identification of trichoscopic differences between female and male patients with AGA, the comparison of more than two types of alopecia regarding trichoscopic findings, numerical calculation of trichoscopic findings for each region, and the discussion of trichoscopic findings leading conceptual confusion are among the superior aspects of our work. The study's limitations include the relatively small number and lack of diversity of patients due to its being conducted at a single center.\u003c/p\u003e \u003cp\u003eIn conclusion, trichoscopy is a useful technique in the differential diagnosis of alopecias. Since the number, occurrence rate, and location of trichoscopic findings are important, trichoscopic evaluation should include all areas of the scalp. Our study may provide more efficient and accurate use of trichoscopy in challenging cases of non-cicatricial alopecias. Further studies are needed to standardize trichoscopic findings and eliminate conceptual confusion for effective diagnosis of alopecias.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;sources\u003c/strong\u003e: None\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e: The authors declare that there are no conflicts of interest regarding the publication of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e:\u0026nbsp;Clinical Research Ethics\u0026nbsp;Committee of S\u0026uuml;leyman Demirel University Faculty of Medicine (SD\u0026Uuml;TF) with decision no. 374 dated 29.12.2023\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient Consent on File:\u0026nbsp;\u003c/strong\u003eSigned informed consent forms were obtained from all participants in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eM.G. wrote the main manuscript textI.E. helped with the editing of all stages of the manuscriptM.Y. checked the final version of the manuscriptH.O. helped with the statistical analysis of the data.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHan A, Mirmirani P, editors. Clinical approach to the patient with alopecia. Seminars in cutaneous medicine and surgery; 2006.\u003c/li\u003e\n\u003cli\u003eAlessandrini A, Bruni F, Piraccini BM, Starace M. Common causes of hair loss - clinical manifestations, trichoscopy and therapy. J Eur Acad Dermatol Venereol. 2021;35(3):629-40.\u003c/li\u003e\n\u003cli\u003eKinoshita-Ise M, Sachdeva M. Update on trichoscopy: Integration of the terminology by systematic approach and a proposal of a diagnostic flowchart. The Journal of Dermatology. 2022;49(1):4-18.\u003c/li\u003e\n\u003cli\u003eRudnicka L, Chrostowska S, Kamiński M, Waśkiel-Burnat A, Michalczyk A, Rakowska A, et al. The role of trichoscopy beyond hair and scalp diseases. A review. J Eur Acad Dermatol Venereol. 2023.\u003c/li\u003e\n\u003cli\u003eLacarrubba F, Micali G, Tosti A. Scalp dermoscopy or trichoscopy. Curr Probl Dermatol. 2015;47:21-32.\u003c/li\u003e\n\u003cli\u003eTosti A. 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Evaluation of clinical signs and early and late trichoscopy findings in traction alopecia patients with Fitzpatrick skin type II and III: a single‐center, clinical study. International journal of dermatology. 2017;56(8):850-5.\u003c/li\u003e\n\u003cli\u003eRudnicka L, Rakowska A, Kerzeja M, Olszewska M. Hair shafts in trichoscopy: clues for diagnosis of hair and scalp diseases. Dermatol Clin. 2013;31(4):695-708, x.\u003c/li\u003e\n\u003cli\u003eBlume‐Peytavi U, Blumeyer A, Tosti A, Finner A, Marmol V, Trakatelli M, et al. S1 guideline for diagnostic evaluation in androgenetic alopecia in men, women and adolescents. British Journal of Dermatology. 2011;164(1):5-15.\u003c/li\u003e\n\u003cli\u003eAfifi L, Oparaugo NC, Hogeling M. Review of traction alopecia in the pediatric patient: Diagnosis, prevention, and management. Pediatric Dermatology. 2021;38:42-8.\u003c/li\u003e\n\u003cli\u003eDe Souza B, Tovar-Garza A, Uwakwe LN, McMichael A. Bitemporal Scalp Hair Loss: Differential Diagnosis of Nonscarring and Scarring Conditions. J Clin Aesthet Dermatol. 2021;14(2):26-33.\u003c/li\u003e\n\u003cli\u003eAl-Dhubaibi MS, Alsenaid A, Alhetheli G, Abd Elneam AI. Trichoscopy pattern in alopecia areata: A systematic review and meta-analysis. Skin Res Technol. 2023;29(6):e13378.\u003c/li\u003e\n\u003cli\u003eRakowska A, Slowinska M, OLSzEWSKA M, RuDNICKA L. New trichoscopy findings in trichotillomania: flame hairs, V-sign, hook hairs, hair powder, tulip hairs. Acta Derm Venereol. 2014;94(3):303-6.\u003c/li\u003e\n\u003cli\u003eKhutsishvili N, Rudnicka L, Ovcharenko Y, Starace M, Buchukuri I, Pataraia S, et al. Trichoscopy - a valuable tool for identifying conditions mimicking androgenetic alopecia. Int J Dermatol. 2024;63(1):23-31.\u003c/li\u003e\n\u003cli\u003eMathur M, Acharya P. Trichoscopy of primary cicatricial alopecias: an updated review. J Eur Acad Dermatol Venereol. 2020;34(3):473-84.\u003c/li\u003e\n\u003cli\u003eKhare S, Behera B, Ding DD, Lallas A, Chauhan P, Enechukwu NA, et al. Dermoscopy of Hair and Scalp Disorders (Trichoscopy) in Skin of Color - A Systematic Review by the International Dermoscopy Society \u0026quot;Imaging in Skin of Color\u0026quot; Task Force. Dermatol Pract Concept. 2023;13(4 s1).\u003c/li\u003e\n\u003cli\u003ePirmez R. The dermatoscope in the hair clinic: Trichoscopy of scarring and nonscarring alopecia. Journal of the American Academy of Dermatology. 2023;89(2, Supplement):S9-S15.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Alopecia, trichoscopic findings, hair, scalp","lastPublishedDoi":"10.21203/rs.3.rs-8880023/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8880023/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/em\u003e: \u003cem\u003eThere is difficulty in the differential diagnosis of noncicatricial alopecia affecting the frontal scalp, and trichoscopy needs to be standardized to improve its accuracy and consistency.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/em\u003e: It is aimed to make differential diagnoses of tractional alopecia (TA), male pattern hair loss (MAGA), female pattern hair loss (FAGA) and telogen effluvium (TE) affecting frontal scalp with trichoscopy and to contribute to trichoscopic standardization.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/em\u003e: The frontal, vertex, temporal and occipital regions were evaluated trichoscopically.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/em\u003e: The hair diameter diversity in the frontal region was significantly more common in the FAGA (90%), MAGA (100%), and TA (89.3%) groups (p\u0026lt;0.001), and was significantly more common in the FAGA (86.7%) and MAGA (76.5%) groups in the vertex (p\u0026lt;0.001), and was significantly more common in the TA (71.4%) group in the temporal region (p\u0026lt;0.001). The mean number of single follicular unit finding in the FAGA (10.70 ± 6.59), MAGA (13.12 ± 9.05), and TA (9.21 ± 3.99) groups were significantly higher in the frontal region (p\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/em\u003e: The single center design and small sample size are limitations of the study.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/em\u003e: Since the number, occurrence rate, and location of trichoscopic findings are important, trichoscopic evaluation should include all areas of the scalp.\u003c/p\u003e","manuscriptTitle":"Is Trichoscopy A Reliable Method For Differantiation Of Frontal Non-Scarring Alopecias?","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-07 10:33:10","doi":"10.21203/rs.3.rs-8880023/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-09T16:35:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"117582697496885142664382024352364044847","date":"2026-04-07T08:16:15+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-01T22:12:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-16T10:08:26+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-16T10:06:50+00:00","index":"","fulltext":""},{"type":"submitted","content":"Archives of Dermatological Research","date":"2026-02-14T12:37:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"b74650df-7a9d-48ac-9970-9ab45222f5e0","owner":[],"postedDate":"April 7th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-07T10:33:10+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-07 10:33:10","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8880023","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8880023","identity":"rs-8880023","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}