HAIR

By Gary M. White, MD

Attachments

Trichomycosis. This most commonly occurs in the groin or axilla.
Trichomycosis

Hair Casts

Pediculosis. Shown here in the pubic area.
Pediculosis in the Pubic Area

Piedra

Circle Hair

Rolled Hair
Rolled Hair

Congenital

Hair Follicle Nevus

Curly Hair

Acitretin Use

Acquired Progressive Kinking Of Hair

Woolly Hair Nevus

Fragile Hair

Bubble Hair: Bubble hair is an acquired hair shaft abnormality characterized by multiple airfilled spaces within the hair shaft. It is a result of thermal injury.

Cartilage-Hair Hypoplasia: Cartilage-hair hypoplasia (CHH) is an autosomal recessive metaphyseal chondrodysplasia characterized by short-limbed short stature and fine, sparse hair.

Ectodermal Dysplasias: Alopecia of the eyebrows along with more generalized hypotrichosis, fragile hair, and other findings may occur in both hidrotic and hypohidrotic ectodermal dysplasia.

Hypotrichosis, Hair Structure Defects, Hypercysteine Hair And Glucosuria [BJD 1996;134;319].

Menkes Disease: The hair is short, scanty and hypopigmented. Pili tort may be found.

Monilethrix: The hair shaft is beaded.

Netherton Syndrome: Congenital, exfoliative erythroderma (but not a collodion baby) is the first sign of this disorder. The ichthyosis linearis circumflexa (double-edged scale with a serpiginous border) is usually not seen until after 2 years of age. The diagnosis is confirmed or made by the finding of trichorrhexis invaginata (bamboo hair) of scalp, vellus or eyelash hair.

Pili Annulati: Pili annulati is a rare hair shaft abnormality characterized by alternating light and dark sections of hair visible to the naked eye occurring randomly. It usually occurs as an isolated finding.

Pili Torti: Pili torti (PT) is a rare structural abnormality of the hair in which the hair is flattened and twisted at regular intervals along the long axis. It may occur in isolation or in conjunction with various conditions including Bjornstad's syndrome (with deafness).
Congenital hypotrichosis and Stargardt macular dystrophy characterized by hair loss, macular degeneration, and progressive loss of vision.
(An Bras Dermatol 88:jan/feb 2013)

Trichorrhexis Nodosa: Trichorrhexis nodosa may be diffuse or localized, and congenial or acquired. Clinically, it appears as multiple, tiny, whitish nodes all over the hair. Fracture of the hair shaft gives the appearance of two opposing paint brushes pushing against each other.

Trichorhinophalangeal Syndrome Type I

Trichothiodystrophy: Trichothiodystrophy is an autosomal-recessive genodermatosis with brittle and sulfur-deficient hair. The hair characteristically shows alternating light and dark bands under polarizing light (“tiger tail” banding which is diagnostic). There may be photosensitivity, ichthyosis, brittle hair, intellectual impairment, decreased fertility, and short stature.

Green

See Green Hair

Heterochromia, Congenital

Scalp Hair Heterochromia in a 5-year-old child thought to represent somatic mosaicism [Peds Derm 2014;31;733]. The lighter hair was blond and not white as in poliosis.

Silvery

Chédiak-Higashi Syndrome

Griscelli Syndrome

Single Hair

Acquired Hypertrichosis Singularis

Tufts Of Hair

Median Nasal Dermoid Fistula
Median Nasal Dermoid Fistula

Tufted Folliculitis
Tufted Folliculitis

Trichofolliculoma
Trichofolliculoma

Trichostasis Spinulosa
Trichostasis Spinulosa

Yellowing

Yellowing of the hair is called xanthotrichosis. It may occur from a wide variety of factors including cigarette smoke, copper, picric acid, resorcinol (dihydroxybenzene), and topical medications e.g., anthralin, minoxidil, selenium sulfide and tar shampoo [Dermatology Online Journal 22;6].

White Forelock

White Forelock

White Nodes

Trichorrhexis Nodosa

White

Leukotrichia

Leukotrichia means white hair. The acute change of dark hairs to light in a localized area may occur in vitiligo, alopecia areata and during the regression of nevi e.g., halo nevi [Indian J Dermatol 2016;61:238].

Canities (Diffuse Whitening Of Hair)

See Graying of Hair

Alternating White and Dark

Flag Sign

Darkening

Diffuse

Repigmentation of prematurely gray/white hair has been reported with various medications including latanoprost, lenalidomide, para-aminobenzoic acid, acitretin, etretinate, corticosteroids, cyclosporine, L-thyroxine, verapamil, tamoxifen, levodopa, cisplatin, erlotinib, adalimumab, nivolumab, pembrolizumab, atezolizumab [JAMA Derm 2017;153;1162] and imatinib [Dermatology Online Journal 21;6].

Localized

Both lentigo maligna and melanoma may cause localized darkening of hair [JAMA Derm 2016;152;81].

Uncombable Hair

Felting. For a picture, see Indian Dermatol Online J 2015;6:310-1

Uncombable Hair Syndrome

Hypertrichosis Facial Vellus Hair

Hypertrichosis Lanuginosa
Hypertrichosis Lanuginosa

Porphyria Cutanea Tarda

Anorexia Nervosa

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