الفهرس 
Hair GROWTH CYCLEOnly 14 pages are availabe for public view
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Abstract
A total of 2250 children were examined at the Dermatology Outpatient Clinic in Misr University for Science & Technology Hospital (MUST) during the period from April 2013 to April 2014 for various clinical dermatological symptoms. Out of these patients, 255 children were complaining of hair loss and scalp disorders with a percentage of (11.3%).
Each child was subjected to clinical and dermoscopic examination by Fotofinder handheld dermoscope (Handyscope) attached to I phone 5.
The patients were classified according to their clinical presentation into acquired cases (98%) or congenital (2%). The focal lesions were (71%) and the diffuse ones were (29%), The Non cicatricial (92.2%) exceeds the cicatricial. The Multiple lesions (75.3%) were more common in children than the single ones (24.7%).
Different causes of hair loss among the 255 studied cases revealed that tinea capitis had the highest percentage (29.8%), followed by traction alopecia (16.9%), and impetigo secondary to pediculosis (15.3%) while (13.3%) were diagnosed as alopecia areata, seborrhic dermatitis & scarring alopecia were (6.7%), trichotillomania (3.1%). psoriasis, pitryasis amenteacea, chemical burn and androgenic alopecia had the same percentages in our study (1.2%).
Also short anagen syndrome, folliculitis decalvans and ectodermal dysplasia had the same percentage (0.8%). While the acne keloidalis and sebaceous nevus showed the least percentage (0.4%).
The most common type was scaly ring worm (23.9%), while the least presentation was the kerion (0.4%). The dermoscopic findings in the Tinea capitis showed that the scales were present in (95.3%) and the characteristic features of tinea capitis were the comma hairs in (37.5%), the corkscrew in (28.1%), the zigzag hairs in (18.8%) & the Morse code was (14.1%) of the cases. The yellow amophorous discharge was seen only in the favus cases with the percentage (3.8%).
The clinical patterns of alopecia areata shows predominance of the patch type (88.2%) and the least type was alopecia universalis (2.9%). The dermoscopic findings in alopecia areata cases showed that the vellus hair and the yellow dots were in (94.1 % & 91.2 % respectively), more than half of the cases showed black dots (58.8 %), the exclamation mark also was obvious in 15 cases (44.1 %).
All the cases with pediculosis showed the translucent, ovoid eggs, firmly attached to hair shaft (nits) & Empty case with plane free ending. More than half of the cases showed erythema, crusts and scale (56.4%).
The dermoscopic findings in Seborrheic dermatitis was the presence of the characteristic finding yellowish scales in a diffuse distribution with arborizing vessels and atypical red vessels. While in psoriasis, the silvery white scales were present with the specific vascular pattern of the including red dots and globules, twisted red loops, and glomerular vessels.
All cases with scarring alopecia showed loss of follicular ostia which is diagnostic and pathognomonic to the disease.
The dermoscopic findings in Trichtillomaina showed hair broken at different lengths & irregular coiled hairs. The black dots and the split ends were (37.5%) and the exclamation mark and the amorphous hair residues were in (25 %).
All patients with Traction alopecia showed hair thinning. The hallmark in Traction alopecia was the hair casts in (62.8%). The exclamation mark was only seen in (1%) of the cases.
Pityriasis amiantacea had yellowish concretions that form thick, matted bundles holding the hairs together resembling amianth or asbestos.
The dermoscopic examination in the chemical burn cases and the short anagen syndrome were non-specific, although the short anagen syndrome patients showed normal hair density & numerous upright regrowing hairs of different lengths.
In patients with Androgenic Alopecia, the vellus hair were more than 20% which is characteristic to this type of alopecia. Folliculitis decalvans and acne keloidalis showed follicular tufts, perifollicular erythema, crusts and pustules. Clinical examination is important to differentiate between folliculitis decalvans and acne keloidalis.
The two cases of ectodermal dysplasia had sparse hairs, most follicular units contain only one hair, hair shafts bend in different directions at irregular intervals, pili torti.
The characteristic clinical and dermoscopic characters of sebaceous nevus revealed the yellow-orange plaque with the warty appearance.
Hair loss is a common problem among Egyptian children. Few studies concerning the use of dermoscopy in the study of hair disease done exclusively on children were found. None of these studies were done in Egypt. So, from this study we can conclude that the routine use of dermoscopy in the clinical evaluation of scalp and hair disorders in children will improve the diagnostic capability beyond simple clinical inspection and will reveal novel features of disease, which may extend clinical and pathogenetic understanding.