Using dermoscopy to detect tinea of vellus hair

Funding sources: none. Conflicts of interest: none declared. Dear Editor, Classically, systemic antifungal treatment is usually mandatory in ringworm affecting cutaneous appendages: the hair or nails. In contrast, in the hairless skin only topical treatment can be used, except in cases of extensive, multiple or recurrent lesions, or in immunocompromised patients. Recently, we described in this journal a new criterion to start systemic antifungal therapy in tinea of vellus hair skin: the observation of parasitized vellus hairs on direct examination.1 To date, 20 isolated cases of ringworm of the vellus hair have been described,1–6 and we reported the largest series of tinea of the vellus hair. We highlighted the potential importance of this finding, which is one cause of resistance to topical treatment in tinea of vellus hair skin.1 We assessed whether dermoscopy could be useful to identify parasitism of vellus hair, in the same way that it has proven useful in the diagnosis of tinea capitis.