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. There are no evidence-based data on how to predict response to therapy in patients with alopecia areata. Objective. The assessment of the predictive value of trichoscopy for the therapeutic outcome in patients with alopecia totalis and universalis. Material and methods. A total of 35 patients (16 with alopecia totalis and 19 with alopecia universalis) were included in the study. Trichoscopy was performed at baseline and 6 weeks after treatment initiation. After 4 months the patients were classified as responders (17/35) and non-responders (18/35). Results. There were no differences between the groups in baseline trichoscopy. In follow-up trichoscopy, pigmented vellus and upright regrowing hairs occurred significantly more often in responders compared to non-responders (16/17, 94% vs. 2/18, 11% and 17/17, 100% vs. 5/18, 28%). No significant difference was observed in the frequency of non-pigmented vellus hairs, non-pigmented upright regrowing hairs, yellow dots, black dots, broken hairs, exclamation mark hairs, tapered hairs, Pohl-Pinkus constrictions and pigtail hairs between responders and non-responders. Conclusions. Trichoscopy performed 6 weeks after treatment initiation is a useful method in predicting the therapeutic outcome in patients with alopecia totalis and universalis. Positive predictive trichoscopic markers include pigmented vellus and upright regrowing hairs.

Pigmented vellus and upright regrowing hairs as the only predictive trichoscopic markers of hair regrowth in alopecia totalis and universalis