"Science begins with measurement“, Dmitry Mendeleev.
Currently Dermatoscopy firmly holds the position of one of the most affordable and effective methods of diagnostiсs in Dermatology. As a science Dermatoscopy received first impact to development in 1663, when Johan Christophorus Kolhaus investigated small vessels of the nail bed with a microscope. In 1920 I. Saphier introduced the term of "Dermatoscopy" and produced detailed description of the possible assessment methods of capillaries in the lower lip by means of Dermatoscope. In 1989 R. Soyer revealed a correlation of Dermatoscopic criteria with underlying histopathological structures. The first conference on Dermatoscopy was held in 1989 in Hamburg, Germany. In 2001 the first World Dermatoscopy Congress took place in Rome, Italy.
Quite recently Dermatoscopy has advanced into another Dermatology field – Trichology. In 1993 Kossard and Zagarella published a case of scarring alopecia in 42-year-old African-American woman and described its diagnostic Dermatoscopic criteria associated with perifollicular fibrosis visualization. First videodermatoscopic criteria of Alopecia Androgenetica severity and ways of dynamic monitoring of the therapy efficacy were described In 2005. Since 2006 Rudnicka introduced the term of Trichoscopy, which has been applied in assessing the condition of the hair, scalp, eyebrows and eyelashes with videodermatoscopic technology. The authors have shown that by means of Trichoscopy it is quite simple to identify such conditions as Moniletrix and other genetic hair diseases. The first Dermatoscopy atlas of hair and scalp was released by A. Tosty in 2007. In 2008 Rudnicka and other coauthors described the diagnostic Trichoscopic criteria of Alopecia Areata with atypical course of progression, when it is difficult to provide evaluation based on clinical symptoms. In authors opinion the leading signs are "yellow dots", cadaverized hair ("black dots"), exclamation mark hair (up to 1 mm length) and dystrophic hair. They also described Vellus hair at Alopecia Areata sites. Perifollicular fibrosis signs in form of “white dots” may be observed in extended courses of this form of alopecia.
As for Alopecia Androgenetica – this condition is easily diagnosed at first site in most cases due to its typical clinical picture. But practice has shown that many professionals tend to confuse a concept of chronic diffuse Telogen Effluvium hair loss and Alopecia Androgenetica in women. The most accurate methods of differential diagnosis of these conditions besides Trichoscopy is a Phototrihogram. Carrying out the Phototrichogram technique with a contrast and a tattoo can rapidly increase the reliable assessment of the treatment dynamics. This has been successfully applied in both scientific and simply routine activities of Trichologists. Specialists in the diagnosis and treatment of hair diseases almost always need to have a reliable information on hair density (number of hairs per square cm) in different areas of the scalp, hair diameters, ratio of Terminal and thinning (Vellus-like) hair, percentage of growing and shedded hairs, etc. To obtain reliable results of these studies the most frequently used methods today are Trichoscopy and Phototrihogram.
Trichoscopy turns to be a newest method for diagnosing hair and scalp diseases. It utilizes Dermatoscopy and Videodermatoscopy technologies for diagnostic visualization and Trichology software tools for studies. Just recently a diagnostic equipment in the office of a Trichologist was usually presented by a microscope, which was passing a diagnostic image on a computer monitor via a microscope or video camera. As a rule, patient had quite a few hairs extracted with their bulbs and shafts carefully examined under a microscope and such approach has been quite a "standard" of the Trichological evaluation for many years. However, lately it has been realized, that these studies are quite uninformative and do not answer many questions. Hair root and shaft research under a microscope allows to distinguish between Anagen and Telogen hair loss; to perform a Trichogram; to diagnose some congenital and acquired hair shaft defects, perhaps, that's all! But how relevant is this information? How often do we have to differentiate between Telogen and Anagen Effluviums? How many times in a practice a Trichologist may meet an inherited hair shaft defects? Approximately one-another a year? And how many specialists are really ready to perfrom on their patients a "true" Classic Trichogram with up to a 100 single hairs extractions in at least two, parietal and occipital, scalp locations at least? On another hand, for any specialist in the field of diagnostics and treatment of hair and scalp disorders and diseases it is quite important to have a reliable information on hair density (number of hairs per square centimeter) in different areas of the scalp; hair diameters; a ratio of thinning (Vellus-like) and healthy (Terminal) hairs; a percentage of growing and shedding hair, calculated using the most advanced method - Digital Phototrichogram. With the development of newer techniques, such as Trichometry, hair loss calculators, follicular unit counts, it has become important to use all these methods in the Trichology practice!
“Science begins with measurement"- these words belong to the famous Russian scientist Dmitry Mendeleev. The most active development of Trichology in Russia has begun in the late 90s of last century. With Trichoscopy introduction and increasing demand for precise measurement and evaluation of various parameters, related to hair normal and pathological conditions, a need for a specific diagnostic and analytic software tool to accommodate all these issues has been arising gradually. The first version of professional computer program TrichoScience © was developed and presented in Moscow, Russia in 2004 by the medical and technical professional team lead by Dr. Vladislav Tkachev, MD, PhD, the vice-chairman of the Russian Trichological Society, the division of the National Alliance of Dermatologists and Cosmetologists of Russian Federation. The software has combined most specific studies in Trichology, accumulated by that time. Due to quick progress in the hair and scalp disorder studies and rapid advances in the diagnostics of various hair diseases, the program keeps gradually updating and expanding with new specific techniques and analyses in Trichology. By present time the program has got the total of twelve versions (2016) and is being successfully used in various countries worldwide.