Plica neuropathica in severe reactive depression: clinical and trichoscopic features

Setó-Torrent, N; Iglesias‐Sancho, Maribel; Sola-Casas, María de los Ángeles; Salleras-Redonnet, Montserrat

doi:10.5070/d327553624

Cited by 3 publications

(5 citation statements)

References 5 publications

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“…5 The disorganized behavior and inappropriate self-care observed in patients with psychiatric disorders may increase risk of PN development. 6,7 PN is overrepresented among patients with mental disorders. 17 However, few cases of psychological disturbances have been described in the literature.…”

Section: Discussionmentioning

confidence: 99%

“… 3–5 Its trichoscopic features include 180° twisted hair, honey-colored concretions resembling a “wrangled mesh of wires” appearance, fractured hair shafts, and trichorrhexis nodosa. 3 , 6 PN is considered a relatively rare condition with an unknown incidence; however, a female predilection has been documented, likely since women tend to have longer hair and increased risk of developing psychological disorders. 7–9 …”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] Its trichoscopic features include 180° twisted hair, honey-colored concretions resembling a "wrangled mesh of wires" appearance, fractured hair shafts, and trichorrhexis nodosa. 3,6 PN is considered a relatively rare condition with an unknown incidence; however, a female predilection has been documented, likely since women tend to have longer hair and increased risk of developing psychological disorders. [7][8][9] PN was initially reported by Le Page in 1884, who described a 17-year-old female patient suffering from hysteria, whose hair was tangled into a solid mass that she could not untangle.…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23][24][25] Treating PN is challenging because simple modalities such as manual separation and soaking with organic solvents are usually unsuccessful. 3,6 Based on current evidence, cutting matted hair is the most effective option. In individuals with anagen effluvium associated PN (ie chemotherapy and severe illness), whose matted hair eventually falls out, hair regrowth can occur normally without treatment.…”

Section: Discussionmentioning

confidence: 99%

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Plica Neuropathica as a Presenting Rare Dermatologic Symptom of Schizophrenia

Piyanonpong¹,

Suchonwanit²

2023

CCID

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Plica neuropathica (PN), also known as plica polonica, trichoma, matting, felting, or bird’s nest hair, is a common but rarely reported hair disorder. It is characterized by the abrupt onset of irreversible hair entanglement, forming a densely matted hair mass. PN has been associated with the use of ionic or herbal shampoos, vigorous hair care practice, self-neglect, systemic infection, parasitic infestation, immunosuppressive drugs, and psychiatric conditions. However, literature supporting the coexistence of PN in psychiatric disorders is scarce. PN may be one of the presenting symptoms observed by physicians. In some cases of psychiatric illness, patients consult more readily with non-mental health professionals than psychologists or psychiatrists. To highlight this issue, we herein report a case of PN in a 32-year-old woman with a 1-month history of being unable to detangle her hair. The patient initially visited the dermatology department and was subsequently diagnosed with schizophrenia following psychiatric consultation. After establishing the fundamental diagnosis apparently underlying the PN, psychiatric treatment with antipsychotic medication and dermatological treatment of the hair condition were instituted. There was an improvement in both at the four-week follow-up. This case history highlights a rare presentation of schizophrenia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Plica Neuropathica as a Presenting Rare Dermatologic Symptom of Schizophrenia

Piyanonpong¹,

Suchonwanit²

2023

CCID

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“…Clinically, PN presents as a compact and impenetrable mass of scalp hair with irregular twists, held together by dirt and exudate. Trichoscopy can provide valuable clues for an accurate diagnosis, such as fractured hairs, bent hair shafts, trichorrhexis nodosa, retained telogen hairs, and twisted hairs [10]. Additionally, honey-colored concretions resembling a "tangled mesh of wires" have been described [11].…”

Section: Discussionmentioning

confidence: 99%

Plica Neuropathica in 2 Hispanic Patients

Asz-Sigall,

Ramos-Cavazos,

Gay-Muñoz

et al. 2023

Skin Appendage Disord

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Introduction: Plica neuropathica (PN) is a rare, acquired, and irreversible condition characterized by the formation of a compacted mass of tangled hair held together by a hard keratin cement. Case Presentation: In case 1, a 50-year-old woman with history of contact dermatitis of the scalp presented with hair tangling and difficulty combing. Physical examination revealed a matted mass of hair with a dirty appearance and non-scarring alopecia. Case 2 involved a 46-year-old woman who experienced spontaneous hair matting after using various products, resulting in a dreadlock-like appearance. Clinical examination showed a compact and matted mass of hair with irregular twists, dirt, and yellowish exudate. Conclusion: PN’s exact pathogenesis is not fully understood, but it is believed to involve physical and chemical insults to the hair shaft. Risk factors include self-neglect, hair felting or rubbing, certain substances, religious practices, chemotherapy, immunosuppressive drugs, infections, and contact dermatitis. Trichoscopy can provide valuable clues for an accurate diagnosis, such as fractured hairs, bent hair shafts, trichorrhexis nodosa, retained telogen hairs, and twisted hairs. Treatment involves cutting the matted hair, and early-stage manual separation may be beneficial.

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Clinicodemographic Features of Plica Neuropathica: A Cross-Sectional Prospective Study

El-Hamd,

Mohamed

2024

Indian Dermatology Online Journal

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Introduction: Plica neuropathica (PN) is an acquired hair disorder characterized by sudden onset, irreversible hair matting, which seems to be a compact hair mass with irregular twists. Aim and Objective: This study aimed to evaluate the clinicodemographic features of PN. Materials and Methods: This study was a cross-sectional prospective clinical research that included patients with PN. All the included patients were subjected to a detailed medical history of clinicodemographic data and clinical with trichoscopic examinations of the affected hair and scalp. Results: This study included 18 female patients with PN, with a mean age of 23.94 ± 7.9. All the patients presented with PN had acute onset and progressive course, psychological stressful factors preceding PN, negligence of hair care, no history of hair care product use, no history of hair straightening, no previous treatment preceding PN, and no history of systemic diseases. Recurrence of PN was reported in 4 (22.2%) patients. On trichoscopic evaluation, all patients were presented with normal scalp and matting of hair shaft with honey-colored concretions mimicking the “wrangled mesh of wires” appearance. Sixteen (88.9%) patients were treated with cutting hair mass. Most of the included patients reported very large and extremely large effects on the quality of life. Conclusion: This study concluded that PN is an uncommon acquired hair matting disorder prevalent in young age females. It is associated with marked impairment of the patient’s quality of life. Psychological stressful factors and negligence of hair care are the main risk factors for PN. Regular hair care measures are essential to prevent hair matting.

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Plica neuropathica in severe reactive depression: clinical and trichoscopic features

Cited by 3 publications

References 5 publications

Plica Neuropathica as a Presenting Rare Dermatologic Symptom of Schizophrenia

Plica Neuropathica as a Presenting Rare Dermatologic Symptom of Schizophrenia

Plica Neuropathica in 2 Hispanic Patients

Clinicodemographic Features of Plica Neuropathica: A Cross-Sectional Prospective Study

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