Trichoscopy as a clue to the diagnosis of scalp sarcoidosis

Background Sarcoidosis is an idiopathic systemic granulomatous disease, in which non-caseating granulomas formations can occur in any organ. Although rare, involvement of the scalp can occur, which might lead to cicatricial alopecia. Dermoscopic features of scalp sarcoidosis had not been reported. Methods Clinical, dermoscopic, and histopathological features of two patients with scalp sarcoidosis were reviewed. Results Two Caucasian female patients aged 22 and 60 years old presented with diffuse folliculitis-like lesions and patchy alopecia, respectively. Dermoscopy of the lesions showed decreased hair density associated with perifollicular and follicular yellowish to pale orange round spots in the first case and diffuse orange discoloration with prominent telangiectasia in the second patient. Few dystrophic hairs were seen in both cases. Conclusions The orange spots seen at trichoscopy of lesions in scalp sarcoidosis may represent a clue to the diagnosis of this condition. Dystrophic hairs may indicate granulomatous activity.