Diagnostic Utility Of Trichoscopy In Tinea Capitis A Systematic Review of Studies Using Mycological Confirmation
DOI:
https://doi.org/10.30651/pc.v1i2.33429Kata Kunci:
tinea capitis, trichoscopy, diagnostic accuracy, fungal cultureAbstrak
Background: Tinea capitis can mimic alopecia areata, seborrhoeic dermatitis, psoriasis and bacterial folliculitis. Mycological confirmation remains important, but potassium hydroxide microscopy is operator dependent and fungal culture may delay diagnosis. Trichoscopy enables rapid visualisation of characteristic hair-shaft and scalp abnormalities.
Objective: To evaluate the diagnostic utility of trichoscopy in tinea capitis, including diagnostic accuracy, common signs and associations with dermatophyte species.
Methods: Original human studies published from January 2016 to 27 July 2026 were identified through PubMed/MEDLINE, PubMed Central, publisher platforms and citation lists. Eligible studies assessed trichoscopy or scalp dermoscopy and incorporated potassium hydroxide microscopy, fungal culture and/or polymerase chain reaction. Findings were narratively synthesised because of heterogeneity.
Results: Eight studies involving 640 participants were included. One prospective multicentre study reported 94% sensitivity, 83% specificity, 92% positive predictive value and 86% negative predictive value for at least one typical trichoscopic feature. Comma hairs, black dots, broken hairs and scaling were common. Reported species-associated patterns varied across geographic settings.
Conclusion: Trichoscopy is a rapid adjunct for recognising tinea capitis and prioritising mycological testing. It should not replace potassium hydroxide microscopy or fungal culture, while species prediction remains insufficiently reliable for treatment decisions.
Referensi
Ali, A. I., Aden, A. I., & Mohamud, A. K. (2024). Dermoscopic findings in tinea capitis among
under 18 children in dermatology polyclinic patients: A hospital-based cross-sectional
study. Annals of Medicine and Surgery, 86(1), 121–126.
doi:10.1097/MS9.0000000000001530
Amer, M., Helmy, A., & Amer, A. (2017). Trichoscopy as a useful method to differentiate
tinea capitis from alopecia areata in children at Zagazig University Hospitals.
International Journal of Dermatology, 56(1), 116–120. doi:10.1111/ijd.13217
Aqil, N., BayBay, H., Moustaide, K., Douhi, Z., Elloudi, S., & Mernissi, F. Z. (2018). A
prospective study of tinea capitis in children: Making the diagnosis easier with a
dermoscope. Journal of Medical Case Reports, 12, 383. doi:10.1186/s13256-018-1914-
6
Azulay-Abulafia, L., Giraldelli, G., Alves, A. L., Baka, J., & Tavares Rodrigues, F. (2025).
Can trichoscopy suggest the agent in tinea capitis?. Skin Appendage Disorders, 11(2),
128–134. doi:10.1159/000541672
Bhat, Y. J., Keen, A., Hassan, I., Latif, I., & Bashir, S. (2019). Can dermoscopy serve as a
diagnostic tool in dermatophytosis? A pilot study. Indian Dermatology Online Journal,
10(5), 530–535. doi:10.4103/IDOJ.IDOJ_423_18
Bourezane, Y., & Bourezane, Y. (2017). Analysis of trichoscopic signs observed in 24 patients
presenting tinea capitis: Hypotheses based on physiopathology and proposed new
classification. Annales de Dermatologie et de Vénéréologie, 144(8–9), 490–496.
doi:10.1016/j.annder.2016.12.012
Brasileiro, A., Campos, S., Cabete, J., Galhardas, C., Lencastre, A., & Serrão, V. (2016).
Trichoscopy as an additional tool for the differential diagnosis of tinea capitis: A
prospective clinical study. British Journal of Dermatology, 175(1), 208–209.
doi:10.1111/bjd.14413
Dalal, A., Chawla, S., Vohra, P., Sangwan, J., & Janshruti. (2022). Clinico-mycological profile
and trichoscopic findings among pediatric tinea capitis patients: A cross-sectional study
from northern India (Haryana). Asian Journal of Medical Sciences, 13(10), 126–132.
doi:10.3126/ajms.v13i10.44730
Dhaille, F., Dillies, A.-S., Dessirier, F., Reygagne, P., Diouf, M., Baltazard, T., ... Chaby, G.
(2019). A single typical trichoscopic feature is predictive of tinea capitis: A prospective
multicentre study. British Journal of Dermatology, 181(5), 1046–1051.
doi:10.1111/bjd.17866
Errichetti, E., Pietkiewicz, P., Salwowska, N., Szlązak, P., Żychowska, M., & Bhat, Y. J.
(2024). Dermoscopy in tinea capitis/barbae and tinea of glabrous skin: A comparative
analysis between polarized and ultraviolet-induced fluorescence examination to
differentiate Microsporum from Trichophyton infections. Photodermatology,
Photoimmunology & Photomedicine, 40(5), e12999. doi:10.1111/phpp.12999
Kumar, P., Pandhi, D., Bhattacharya, S. N., & Das, S. (2020). Trichoscopy as a diagnostic tool
for tinea capitis: A prospective, observational study. International Journal of
Trichology, 12(2), 68–74. doi:10.4103/ijt.ijt_30_20
Meghwal, L., Mehta, S., Gupta, L. K., Balai, M., & Mittal, A. (2024). Trichoscopic and clinico-
morphological evaluation of tinea capitis. Indian Dermatology Online Journal, 15(3),
437–442. doi:10.4103/idoj.idoj_439_23
Meneses, O. M., Donati, A., Silva, F. O., Mimiça, M. J., Machado, C. J., & Veasey, J. (2023).
Trichoscopy patterns of tinea capitis and their correlation with mycological culture
results. Journal of the American Academy of Dermatology, 88(1), 166–167.
doi:10.1016/j.jaad.2021.12.010
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ...
Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting
systematic reviews. BMJ, 372, n71. doi:10.1136/bmj.n71
Tran, T. Q. T., Kim, G., Ryu, H.-J., Park, S.-K., Nam, K.-H., Yun, S.-K., ... Park, J. (2026).
Dermoscopic features of tinea capitis in Korean patients: Correlation with clinical
subtypes, age groups and causative dermatophytes. Mycoses, 69(5), e70184.
doi:10.1111/myc.70184
Waśkiel-Burnat, A., Rakowska, A., Sikora, M., Ciechanowicz, P., Olszewska, M., & Rudnicka,
L. (2020). Trichoscopy of tinea capitis: A systematic review. Dermatology and
Therapy, 10(1), 43–52. doi:10.1007/s13555-019-00350-1
