Hair casts. A clinical and morphologic study

Taı̈eb, Alain

doi:10.1001/archderm.121.8.1009

Cited by 8 publications

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“…6 Bayerl et al 7 described the case of a male patient who presented an association of lichen ruber follicularis and Brocq's pseupelade. HCs have also been associated to an important psychological trauma by Held et al 8 seems that the first description in Brazil was made by Hirata et al, 2 who described a case of yellow-skined twins from Ibiúna, SP, presenting HC as confirmed by both optic and electronic microscopy, after negative mycological exams.…”

Section: Discussionmentioning

confidence: 99%

“…Once again, Keipert 15 presented three more cases in boys and, when reviewing literature, mentioned that almost all cases until then had been described in girls. Taïeb et al 6 des -cribed the disease in two girls, one five and other seven years old, reporting that the use of a 0.025% tretnoin lotion had been effective in treating the condition. Even though HC are benign and low-morbidity conditions, the fact that they are little known leads to frequent diagnostic confusion, which may generate unnecessary costs and anxiety for both patients and physicians.…”

Section: Scottmentioning

confidence: 99%

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Cilindros capilares: relato de três casos e revisão da literatura

Minelli¹,

Gon²,

2006

An. Bras. Dermatol.

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Hair casts are small white yellowish keratinous structures that totally wrap the hair shaft. They are characterized by asymptomatic, semifirm, tannish, freely movable, cylindrical masses, distributed along the scalp hair. This condition has been found in three women, whose case histories are described. INTRODUCTIONHair casts (HC) are characterized by white yellowish cilindrical concretions that involve hair shaft, but do not adhere to it. On the contrary, they slide through hairs when tractioned.1-3 They were first described in 1957 by Kligman 3 and, even though they are not unusual, there is scarce literature on it. These structures measure from three to 7mm in length, and they have variable location throughout scalp. They may occur in small or large numbers, and their importance lies in the fact that they are frequently confounded with othere common diaseases of the scalp, such as pediculosis, white piedra and seborrheic dermatitis, for instace. According to the literature and the author's experience, false diagnoses are common, which implies inadequate treatment and becomes a reason for both patient and physician anxiety.Below, three cases are reported on women affecetd by this condition, the initial diagnosis of which involved other diseases; besides, a brief literature review is presented. CASE REPORTS Case 1White single 20-year-old female patient, born at and coming from Cambé, PR, who sought assistance claiming to have noticed the presence of many louse eggs two weeks before, with no pruritus. She then requested her sister to verify the region and, as she expected, no louse was found. On examination, she presented a great amount of white spots sorrounding hairs in all their extension (Figure 1). The scalp had normal aspect, and no parasites were detected. With a diagnostic hypothesis of white piedra, a mycological test was requested, with negative result. On reevaluation, the patient herself called attention to the fact that lesions were withdrawable by simple sliding through the hair shaft, as if removing beads from a necklace. She added that although she had aquired this habit, new lesions kept being formed. Based on these facts and on microscopic examination of hairs (Figures 2 and 3), and with the aid of literature, we confirmed the clinical diagnosis of hair casts. Because the patient was pregnant, an expecting approach was employed, with spontaneous resolution after delivery. Case 2White 48-year-old retired widowed female coming from Londrina, PR, bearing psoriasis for years, reported the appearance of whitish concretions (Figure 4) disposed along hairs, as well as psoriatic desquamation on scalp. Such formations also slided as far as the distal hair extremity when tractioned. After receiving the clinical diagnosis of hair casts associated to psoriasis, she was treated with tar shampoo and capillary betametasone, with improvement of the condition. Case 3White 13-year-old female student coming from Londrina, PR, reported hair lesions with no pruritus for weeks. On examination, small whit...

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Section: Discussionmentioning

confidence: 99%

Section: Scottmentioning

confidence: 99%

Cilindros capilares: relato de três casos e revisão da literatura

Minelli¹,

Gon²,

2006

An. Bras. Dermatol.

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“…Hair casts, although sharing a similar appearance, can have two radically different aetiologies, thus belonging to one of two heterogeneous types: (i) common type and (ii) uncommon type 5,6 , 9 . Another proposed classification divides hair casts into two groups based on their cellular nature: peripilar keratin and peripilar non‐keratin casts 1 .…”

Section: Discussionmentioning

confidence: 99%

“…This hair disorder of unknown pathogenesis is rarely mentioned in the dermatological literature 1 . There is some confusion regarding the aetiology and nomenclature of this disorder, although there are a few reports describing the microscopic and ultrastructural features 1–5 and investigating their elemental composition 6 …”

Section: Introductionmentioning

confidence: 99%

Hair casts due to a deodorant spray

Ena¹,

Mazzarello

Chiarolini³

2005

Aust J Dermatology

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A 7-year-old girl presented with itching and greyish-white sleeve-like structures in her hair. After ruling out other possible causes for the symptoms, such as nits and dandruff, it was determined that the patient was affected by hair casts. These are small cylindrical structures resembling louse eggs that encircle individual scalp hairs and are easily movable along the hair shafts. It was concluded that she had induced the condition through misuse of a deodorant body spray. Scanning electron microscopy combined with electron dispersive X-ray analysis (X-ray microanalysis) of the hair casts showed the chemical nature of the structures. Some elements present in the composition of the ingredients of the deodorant spray, such as aluminium, chlorine, silicon, magnesium and carbon, were also present in this uncommon type of hair casts.

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“…They are classified as primary when there is no associated scalp cond ition, and as secondary when associated with scaling scalp conditions such as seborrheic dermatitis and psoriasis. 2,3 The differential diagnosis includes dandruff, white piedra, trichorrehexis nodosa, monilethrix, trichomycosis and trichonodosis.…”

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confidence: 99%

Hair casts (pseudonits)

Ruiz‐Villaverde

Galán‐Gutiérrez

2012

CMAJ

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A 9-year-old girl was referred to our dermatology clinic for an assessment of whitish granules attached to her hair. She was otherwise healthy and had no history of pruritis of the scalp. Her parents had noticed the granules 8 months previously, and she had already received antiscabetic and antifungal treatments (3 weekly courses of 1.5% permetrin lotion, and daily ketoconazole shampoo for 2 mo). On physical examination, we found easily sliding, whitish structures encircling the shafts of the patient's hair (Figure 1A and 1B). She did not have alopecia, and her scalp was not inflamed. A full inspection of the patient's skin was normal. We diagnosed pseudonits and prescribed a keratolytic lotion of 3% salicylic acid. In addition, we recommended using a thin-tooth comb and avoiding traction movements when combing the hair. At a 2-month follow-up, the pseudonits had resolved almost completely.Peripillous sheaths, also called pseudonits or hair casts, are white-to-yellow tubular structures that encircle the proximal hair shafts of the scalp. Varying in length (2-7 mm), pseudonits slide easily along the shaft without breaking it.1 Pseudo nits consist of keratinized cells from both the internal and the external epithelial sheaths of the hair root. They are classified as primary when there is no associated scalp cond ition, and as secondary when associated with scaling scalp conditions such as seborrheic dermatitis and psoriasis.2,3 The differential diagnosis includes dandruff, white piedra, trichorrehexis nodosa, monilethrix, trichomycosis and trichonodosis.Pseudonits can be differentiated from nits by an absence of pruritis and by their mobility along the hair shaft -nits do not slide. If available, dermoscopic examination will show the tubular shape of pseudonits, which helps differentiate them from nits, which are oval. 4,5 In addition to physical removal, keratolytic lotions or shampoos are helpful. França and colleagues 1 have described resolution with a solution of 0.025% retinoic acid, and we have seen good results with a 3% salicylate lotion; both of these agents are keratolytics.

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Hair casts. A clinical and morphologic study

Cited by 8 publications

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Cilindros capilares: relato de três casos e revisão da literatura

Cilindros capilares: relato de três casos e revisão da literatura

Hair casts due to a deodorant spray

Hair casts (pseudonits)

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