[Two new trichoscopic signs in alopecic and aseptic nodules of the scalp: "Eastern pancake sign" and comedo-like structures].

Background: The purpose of this study is to describe two new trichoscopic signs, "Eastern pancake sign" and "comedo-like structures", not previously reported to our knowledge and seen in 5 patients with alopecic and aseptic nodules of scalp (AANS).
Patients and Methods: We report on 5 patients presenting AANS. Demographic and ethnic characteristics, disease duration, clinical description, treatment and evolution were noted. Trichoscopy was performed for all patients.
Results: In all cases of NAAS, trichoscopy revealed 2 signs: "Eastern pancake sign" resulting in heterogeneous dilated follicular orifices without trichoscopic signs of alopecia areata, and "comedo-like structures" resembling comedones.
Discussion: To our knowledge, there have been no previous reports in the literature of the 2 new trichoscopic signs of AANS described herein: "Eastern pancake sign" and "comedo-like structures". The trichoscopic feature of comedo-like structures suggests the potential role of follicular occlusion in this disease. We consider that follicular occlusion may be a triggering factor in AANS.
(Copyright © 2014 Elsevier Masson SAS. All rights reserved.)