Multiple Hair Whorls in a Child with Normal Cranial and Neurologic Development

Abstract

Hair whorls are a normal characteristic of the human scalp and abnormally placed or absent whorls have been associated with cranial or neurologic abnormalities. We report a case of multiple whorls in a child with normal neurologic development. We also include a brief review of the literature on the development of hair whorls and their associations.

Scalp hair whorl patterns in patients affected by Neurofibromatosis Type 1: A case-control study

“…A genetic factor conditioning scalp whorl patterning has been put forward in order to explain hair whorl formation in scalp areas lacking mechanical tension forces during embryogenesis. [ 17 ] This theory has been validated by investigations based on the study of left-handedness, counterclockwise scalp whorls, and atypical right hemisphere location of the language center. [ 20 ]…”

“…[ 6 ] Moreover, multiple hair whorls have been associated with facial dysmorphisms and inflammatory dermatological diseases such as guttate psoriasis. [ 16 17 ]…”

“…Based on the previous observations, atypical localization or an increased number in hair whorls does not necessarily imply any disease, since in healthy individuals, hair whorls with atypical localizations, spins, or numbers may be observed. [ 17 ]…”

Nevus Sebaceus Arising Within a Scalp Whorl of a Healthy Male Neonate

“…A single hair whorl or multiple hair whorls may be present. While hair whorls can be a normal feature of the human scalp and are mostly seen in healthy children without underlying issues, some case reports have described atypically placed, or even absent, scalp whorls being associated with underlying cranial or neurologic anomalies such as abnormally formed skull or incomplete brain development, or even associated with syndromes like neurofibromatosis type 1 [1,[9][10][11][12][13][14]. Similarly, a "hair collar sign" can also indicate the presence of an underlying cranial defect but is defined as a ring of hypertrichosis around the periphery of a lesion rather than a spiraling growth pattern of hair [15].…”

“…Hair whorls are typically located on the vertex scalp and present as circular arrangements of hair. Atypically placed, or absent, scalp whorls have been associated with abnormal brain development [8][9][10][11][12][13][14]. In these cases, further imaging and work-up may be necessitated to rule out intracranial abnormalities.…”