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: August 1, 2004
CHIEF COMPLAINT: Change in hair texture and hair color
CLINICAL HISTORY: A 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. The mother denies any hair loss or breakage. The patient is otherwise healthy. Growth and development have been normal. The patient takes no medicines. The patient’s 1-year-old sister is now experiencing similar complaints. The 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: N/A
DERMATOHISTOPATHOLOGY:
The light microscope shows normal hair shafts, without evidence of grooves.
The scanning electron microscope, on cross-sectioning, reveals triangular-shaped hairs with indentation, giving the hair a reniform to heart-shaped.
DIFFERENTIAL DIAGNOSIS:
1. Pili torti
2. Uncombable hair syndrome
3. Monilethrix
4. Trichorrhexis nodosa
5. Trichorrhexis invaginata
