Earlier we commented on alopecia areata (AA) incognita and concluded that the condition does not represent a nosologic entity in its own right that is distinct from diffuse AA, and that the term is an oxymoron, an apparent self-contradiction to reveal a paradox [1]. Losing hair without an apparent reason may indeed represent a paradox. However, the skin and hair are gratifying for diagnosis. One has but to look, and recognize, since everything to be named is in full view. To reach the level of artistry, looking must be a skillful active undertaking. The informed look is the one most practiced by dermatologists, it comes from knowledge, experience and visual memory.

Studies have suggested that dermoscopy of the hair and scalp (trichoscopy) may improve diagnostic capability beyond simple clinical inspection. Indeed, with the introduction of trichoscopy there has been a significant rise of peer-reviewed publications on AA incognita following the original report and hypothesis of Rebora in 1987 [2]. And yet, the first report delineating diffuse AA from telogen effluvium was made as early as 1962 [3], underlining the diagnostic aptitude of the clinical dermatologists of the past.

Yet another condition more recently proposed by the same school of trichoscopy, is trichotillomania incognito. The authors reported two pediatric cases of trichotillomania without patches, in which they highlight the relevance of trichoscopy for the respective diagnosis. In fact, these cases did not fulfil the Diagnostic and Statistic Manual of Mental Disorders-5 criteria for diagnosis of trichotillomania, despite the presence of the respective trichoscopic features [4].

Finally, the term tinea incognito has been used for a condition of fungal skin infection in which the typical clinical presentation is altered through corticosteroid or other immunosuppressive therapies. Again, dermoscopy is suggested to be a useful diagnostic tool, by visualization of specific microscopic hair changes of tinea, like morse-code hairs, comma and corkscrew hairs and others [5].

Trichoscopy has gained popularity in the differential diagnosis of hair and scalp disorders. Nevertheless, as a diagnostic procedure, trichoscopy is to be understood as representing an integral part of a more comprehensive dermatological education and patient evaluation. In fact, as with any medical problem, the patient complaining of hair loss requires a medical and exposures history, physical examination, and appropriate laboratory work-up.

Dermatology represents the only medical discipline in which the adjective “incognito” is used in the nomenclature of specific conditions, with the particular favor of trichoscopy. And yet, dermatology is the specialty in which the pathology is in full view, as opposed to internal medicine and other medical disciplines. Therefore, we would like to discourage the further use of the adjective “incognito” in dermatological terminology for the sake of a stringent nosologic classification and nomenclature of diseases. Once the respective nosologic entities identified, the specific conditions are no longer unrecognized, and the adjective indeed represents no more than an oxymoron downplaying our clinical astuteness as dermatologists beyond the signature patterns of trichoscopy.