A Closer Look at Alopecia Areata in Black Patients: Are We Missing Key Diagnostic Clues?
Alopecia areata (AA) is more prevalent in patients with skin of color —but how well are we actually identifying it in clinical practice? Trichoscopy is a critical tool in diagnosing AA, yet most of what we know comes from studies in lighter skin types. That may be leaving gaps in recognition—and care—for Black patients.
A new study in JDD helps fill that gap by analyzing trichoscopic findings in Black patients with AA. The review of 10 patients revealed not only classic signs like vellus hairs and black dots but also underreported features such as peripilar hyperpigmentation, follicular hypopigmentation, diffuse erythema, uninterrupted honeycomb patterns, and perifollicular scale.
Interestingly, these features didn’t correlate with disease severity based on SALT scores—suggesting that visual clues alone may not always reflect disease burden.
This work highlights the urgent need for broader trichoscopic pattern recognition in diverse populations and may lower the threshold for identifying co-existing or alternative alopecias earlier in the diagnostic process.
Are you seeing what you need to see?
J Drugs Dermatol. 2025;24(7). doi:10.36849/JDD.9139
Blog write-up assisted by AI
