Highlights
- •Ultra high-frequency ultrasound (uHFUS) is a new diagnostic modality.
- •uHFUS detects pathological findings which are not observable by other diagnostic tools.
- •uHFUS may facilitate more convenient, prompt, and precise diagnosis of hair disorders.
Abstract
Background
Ultra high-frequency ultrasound (uHFUS) is a recently developed diagnostic technology.
Despite its potential usefulness, no study has assessed its advantage in diagnosis
and evaluation of hair disorders in comparison with other diagnostic methods.
Objectives
To assess the practicability of uHFUS in diagnosing hair disorders and propose a diagnostic
methodology.
Methods
Ultrasonographic images of scalp and forehead from patients with hair disorders (n
= 103) and healthy controls (n = 40) were obtained by uHFUS and analyzed by both descriptive
and numerical parameters. Furthermore, the data were compared with trichoscopic and
histopathological findings.
Results
The pattern of inflammation and fibrosis, hair cycle abnormality, and the findings
in subcutis were detected by uHFUS. Significant differences were noted in the numerical
parameters associated with the number of hair shafts and follicles, hair diameters
and their diversity, and dermal echogenicity in both cicatricial and non-cicatricial
hair disorders. Findings in uHFUS were associated with those observed in trichoscopy
and scalp biopsy but uHFUS was able to detect pathological findings associated with
hair cycle, inflammation, fibrosis, and subcutaneous abnormalities, which are hardly
assessable by trichoscopy.
Conclusion
The findings of this study highlighted usefulness of uHFUS in diagnosing hair disorders,
while overcoming the weaknesses and limitations of other diagnostic tools.
Abbreviations:
AA (alopecia areata), AGA (androgenetic alopecia), CCCA (central centrifugal cicatricial alopecia), DC (dissecting cellulitis), FD (folliculitis decalvans), FFA (frontal fibrosing alopecia), FPHL (female pattern hair loss), HF (hair follicle), (u)HFUS ((ultra) high-frequency ultrasound), HS (hair shaft), LPP (lichen planopilaris), SA (senescent alopecia), TE (telogen effluvium)Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Dermatological ScienceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Hair and scalp dermatoscopy.J. Am. Acad. Dermatol. 2012; 67: 1040-1048
- Seventy-MHz ultrasound detection of early signs linked to the severity, patterns of keratin fragmentation, and mechanisms of generation of collections and tunnels in hidradenitis suppurativa.J. Ultrasound Med. 2020; 39: 845-857
- Skin imaging using ultrasound imaging, optical coherence tomography, confocal microscopy, and two-photon microscopy in cutaneous oncology.Front. Med. (Lausanne). 2019; 6: 274
- High-frequency ultrasonography of the scalp - Comparison of ultrasound and trichoscopic images in healthy individuals.Skin Res. Technol. 2020;
- Micro-ultrasound imaging for accuracy of diagnosis in clinically significant prostate Cancer: a meta-analysis.Front. Oncol. 2019; 9: 1368
- High-frequency micro-ultrasound imaging and optical topographic imaging for spinal surgery: initial experiences.Ultrasound Med. Biol. 2018; 44: 2379-2387
- Sonography in pathologies of scalp and hair.Br. J. Radiol. 2012; 85: 647-655
- Ultrasound characteristics of the hair follicles and tracts, sebaceous glands, montgomery glands, apocrine glands, and arrector pili muscles.J. Ultrasound Med. 2019; 38: 1995-2004
- Immune checkpoint inhibitor-related alopecia: insight into the pathophysiology utilizing non-invasive diagnostic techniques.J. Dermatol. 2019; 46: e152-e153
- Ultrasound and infrared-based imaging modalities for diagnosis and management of cutaneous diseases.Front. Med. (Lausanne). 2018; 5: 115
- Ultrasonographic characteristics of frontal fibrosing alopecia.Int. J. Trichology. 2019; 11: 183-184
- In vivo visualization of hair follicles by ultrasound biomicroscopy in alopecia areata and its correlation with histopathology.Acta Dermatovenerol. Croat. 2015; 23: 12-18
- Dissecting cellulitis of the scalp early diagnosed by color doppler ultrasound.Int. J. Trichology. 2017; 9: 147-148
- Overview of ultrasound imaging applications in dermatology.J. Cutan. Med. Surg. 2021; 1203475421999326
- Trichoscopy for common hair loss diseases: algorithmic method for diagnosis.J. Dermatol. 2011; 38: 71-75
- Trichoscopy of alopecia areata: an update.J. Dermatol. 2018; 45: 692-700
- Trichoscopy of primary cicatricial alopecias: an updated review.J. Eur. Acad. Dermatol. Venereol. 2020; 34: 473-484
- Histopathological investigation of clinically non-affected perilesional scalp in alopecias detected unexpected spread of disease activities.J. Dermatol. 2014; 41: 802-807
- An Atlas of Hair Pathology with Clinical Correlations.2012
- Histopathology of scarring and nonscarring hair loss.Dermatol. Clin. 2013; 31: 43-56
- How real is senescent alopecia? A histopathologic approach.Clin. Dermatol. 2011; 29: 49-53
- Lichen planopilaris and frontal fibrosing alopecia as model epithelial stem cell diseases.Trends Mol. Med. 2018; 24: 435-448
Article info
Publication history
Published online: May 01, 2021
Accepted:
April 29,
2021
Received in revised form:
April 26,
2021
Received:
February 12,
2021
Identification
Copyright
© 2021 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.
