“Bubble hair,” a report of two cases

Abstract

Case 1 A 20‐year‐old woman presented with a patchy area of hair loss in the occipital scalp area. The patient's hair care included the use of a blow dryer. Microscopic evaluation of a gentle hair pull revealed vacuolization of the hair shafts. The hair shafts were enlarged in the areas of vacuolization. There was no evidence of dermatophyte hyphae on examination with KOH technique. A diagnosis of bubble hair was made. The patient's alopecia improved with gentle hair care and discontinuation of blow drying. At 1‐year follow‐up, there was no evidence of residual alopecia. Case 2 A 42‐year‐old woman presented with diffuse hair loss and increased hair fragility (Fig. 1). The patient had a history of blow drying her hair with the heat set on the “high” setting on a daily basis. She also reported holding the blow dryer close to her scalp. Examination of her hair shafts revealed multiple areas of vacuolization of the hair shafts (Fig. 2). Examination with KOH technique showed no evidence of dermatophyte hyphae. The patient was instructed to discontinue the use of high heat in her hair care regimen. At 1‐year follow‐up, the patient's alopecia had improved. 1 A 42‐year‐old woman with diffuse thinning and increased fragility of the hair 2 Hair shafts reveal large irregular vacuoles on direct microscopic enduration (unstained × 10 objective)

An uncommon localization of black heels in a free climbing instructor

“…This condition is determined by small lakes of intrakeratinous haemorrhages and sometimes may clinically resemble a wart or a malignant melanocytic lesion. 2 Black heels are seen mostly in young adults who are engaged in athletic activities, including tennis, football, and gymnastics.…”