Hair follicle openings

From dermoscopedia

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 Editor: Anna Waskiel Burnat

 Author(s): Anna Waskiel Burnat     ·  Lidia Rudnicka
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Description This chapter covers the trichoscopyThis glossary term has not yet been described. signs of the follicular opening of hairs
Author(s) Anna Waskiel Burnat · Lidia Rudnicka
Responsible author Anna Waskiel Burnat→ send e-mail
Status released
Status update January 21, 2019
Status by Ralph P. Braun


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"DotsDots are small, round structures of less than 0.1 mm in diameter that have a red color when corresponding to blood vessels; however, when due to melanin, their color ranges from black, brown, to blue-gray depending on the depth and concentration of the melanin in the skin (Tyndall effect)." correspond to hair follicle openingsThis glossary term has not yet been described. observed in trichoscopic examination [1].



Black dotsDots are small, round structures of less than 0.1 mm in diameter that have a red color when corresponding to blood vessels; however, when due to melanin, their color ranges from black, brown, to blue-gray depending on the depth and concentration of the melanin in the skin (Tyndall effect).

Black dots, also known as “cadaverized hairs”, represent pigmented hairs broken or destroyed at scalpThis glossary term has not yet been described. level [1]. They are commonly observed in alopecia areataThis glossary term has not yet been described. [3], dissecting cellulitis [4, 5], trichotillomaniaThis glossary term has not yet been described. [6] and tinea capitisThis glossary term has not yet been described. [4]. Black dots may be also detected in chemotherapy-induced alopecia [4], lichen planopilarisThis glossary term has not yet been described. [7], discoid lupus erythematosusis a chronic skin condition of sores with inflammation and scarring favouring the face, ears, and scalp and at times on other body areas. These lesions develop as a red, inflamed patch with a scaling and crusty appearance. The centre areas may appear lighter in colour with a rim darker than the normal skin. [7], traction



Yellow dots

Yellow dots correspond to follicular infundibula filled with sebum and/or keratotic material [10]. They present as yellow, or whitish, round or polycyclic dots, varied in size and uniformed in colorColor (American English) or colour (Commonwealth English) is the characteristic of human visual perception described through color categories, with names such as red, yellow, purple, or blue., devoid of hairs or containing miniaturized, cadaverized or dystrophic hairs [10-12].
In alopecia areata, yellow dots are characterized by an abundant amount and regular distribution and predominate in long-lasting, inactive disease [3, 13].
The predominance of yellow dots (they are predominantly sebaceous) in the frontal area compared to the occipital area is characteristic for androgenetic alopeciaThis glossary term has not yet been described. [14]. They correspond to empty follicular openings of follicles in kenogen phase.
In discoid lupus erythematosus, large, dark yellow dots that correspond to wide infundibula filled with keratotic material are observed [1, 5].
Yellow dots, appearing as large "3D" soap bubbles imposed over dark dystrophic hairs are specific for dissecting cellulitis [1, 5].
Sparse yellow dots may also be detected in chronic telogen effluviumThis glossary term has not yet been described. [8, 9], traumatic alopecia [8] traction alopecia [7], congenital hypotrichoses and kerion celsi [15].



Red dots

Red dots correspond to widened infundibula plugged by keratin and surrounded by dilated vesselsThis glossary term has not yet been described. and extravasated erythrocytes [16]. They are characteristic trichoscopic finding for active discoid lupus erythematosus and believed to be a positive prognostic factor [5].



White dots

There are two types of white dots.
The classic, big, irregular white dots correspond to areas of perifollicular fibrosis and are observed most commonly in lichen planopilaris [1].
The small, regular pinpoint white dots represent hair follicle openings and eccrine sweat gland openings and are observed in sun exposed areas and in dark skin phototypes regardless of hair loss [1].