Change in the Color and Texture of Hair

Presenter: Scott A. Smith, D.O.; Mary Veremis-Ley, D.O.; Michelle L. Endicott, D.O.; Melissa Camouse, D.O.; Mary A. Evers, D.O.
Dermatology Program: University Hospitals of Cleveland, Richmond Heights
Program Director: Monte Fox, DO
Submitted on: Aug 1, 2004

CHIEF COMPLAINT:  A now,2 year-old girl, presented to the clinic at the age of 11 months. She had a 4-month history of change in the color and texture of her hair. Per the patient’s mother, her hair had gradually gotten lighter, kinkier, and more difficult to comb. Mother denies any hair loss or breakage. Patient is otherwise healthy. Growth and development have been normal. Patient takes no medicines. The patient’s 1 year-old sister is now experiencing similar complaints. Patient’s great aunt had similar hair complaints as a child, which subsequently improved with her age.

PHYSICAL EXAM:

Involving the entire scalp, there are coarse, blonde hairs that are standing away from the scalp. The hairs are resistant to combing flat.

LABORATORY TESTS:

DERMATOHISTOPATHOLOGY:

Light microscope shows normal hair shafts, without evidence of grooves.
Scanning electron microscope, on cross sectioning, reveals triangular shaped hairs with indentation, giving the hairs a reniform to heart shape.

DIFFERENTIAL DIAGNOSIS:

1.   Pili torti
2.   Uncombable hair syndrome
3.   Monilethrix
4.   Trichorrhexis nodosa
5.   Trichorrhexis invaginata


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