A unique approach for investigating skin lesions and their relationship with TCM syndrome differentiation in alopecia areata.

Background: Alopecia areata is also known as 'oil wind' in Chinese medicine. Alopecia areata is a debilitating autoimmune skin disease characterized by patches of non-scarring hair loss and inflammation that damages the scalp and body hair in a variable, often relapsing or permanent fashion. It is not quite obvious how the various Traditional Chinese Medicine (TCM) syndromes differentiate between the skin lesions under dermatoscopy caused by alopecia areata. Objective: This study aimed to provide a rational basis for TCM syndrome differentiation of alopecia areata and investigate the role of skin lesions in various TCM syndromes of alopecia areata under dermatoscopy. Methods: The dermatologist used a dermatoscope to take four images of the patient's skin lesion area and the skin lesion junction. Two of the images were captured with polarized light, while the other two were taken with non-polarized light. Patients with alopecia areata who had TCM syndrome differentiation were identified and examined using dermatoscopy. The occurrence of the yellow dot, white dot, exclamation mark hair and vascular sign, was determined and then statistically analyzed. Results: The positive rates of vascular signs relate to alopecia areata, exclamation mark hair relates to Qi-blood deficiency and white dot corresponded to liver and kidney deficiency. All the positive rates were statistically significant (P < 0.05). Compared to vascular sign, white dot sign, and Qi-blood deficiency syndrome groups, the positive rate of yellow dot syndrome was not significant (P>0.05). Conclusion: The findings suggest that particular skin lesions contribute to differentiating different TCM syndromes associated with alopecia areata. Skin lesions examined under dermatoscopy can assist in diagnosing the TCM syndromes associated with alopecia areata.