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. 2008 Jul 7;2(2):14-20.
doi: 10.3315/jdcr.2008.1009.

Trichoscopy in genetic hair shaft abnormalities

Adriana Rakowska  1 , Monika Slowinska, Elzbieta Kowalska-Oledzka, Lidia Rudnicka
Affiliations

Trichoscopy in genetic hair shaft abnormalities

Adriana Rakowska et al. J Dermatol Case Rep. .

Abstract

Background: Diagnosis of hair shaft abnormalities is based on light microscopic examination of more than 50 plucked hairs. The aim of this study was to verify whether hair shaft abnormalities may be visualized by trichoscopy (hair and scalp videodermoscopy) and to analyze trichoscopic features of common genetic hair shaft dysplasias.

Method: Patients with known genetic hair shaft disorders were included into the study. Trichoscopy was performed with the use of Fotofinder II videodermoscope. Images performed at 20-fold and 70-fold magnification were analysed. In selected cases 160-fold magnification was used for better visualization of hair shafts.

Results: Our results show that characteristic light microscopy features of Netherton syndrome, monilethrix, woolly hair syndrome, pili torti, pili annulati and trichothiodystrophy may be visualized by trichoscopy.

Conclusion: Genetic hair shaft abnormalities may be diagnosed by trichoscopy in a single diagnostic session without the need of plucking or cutting them for diagnostic purposes.

Keywords: alopecia; dermoscopy; hair; trichoscopy; videodermoscopy.

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Figures

Figure 1
Figure 1
Trichoscopy images of (A) Netherton syndrome with trichorhexis invaginata and golf tee like hairs (50-fold magnification); (B) monilethrix - "the regularly bended ribbon sign" (70-fold magnification); (C) woolly hair syndrome - hair shafts resembling a "crawling snake", with ondulations placed very closely together in (70-fold magnification); (D) healthy person's with curly hair - slight variations in hair shaft thickness, when it is evaluated at different lengths (70-fold magnification).
Figure 2
Figure 2
Pili annulati: (A) microscopic examination (x40); (B) trichoscopy image in pili annulati with regular, width, white bands with misty-like appearance (x70); (C) trichoscopy image in normal thick hair shaft with "intermittent medulla symptom", easily mistaken with pili annulati.
Figure 3
Figure 3
Pili torti: (A) microscopic image of hair shaft in pili torti with group of regularly spaced twists; (B) trichoscopy image in pili torti with regular twists of the hair shaft along the long axis (70-fold magnification); (C) trichoscopy image in pili torti with hair shafts acutely bended at different angles at irregular intervals (20-fold magnification).
Figure 4
Figure 4
Trichothiodystrophy: (A) Light microscopy examination (100-fold magnification); (B) trichothiodystrophy in polarizing microscope with tiger tail banding (40-fold magnification); (C) trichoscopy image in trichothiodystrophy - hair shafts with non-homogenous structure of grains of sand and with slightly wavy contour.
See this image and copyright information in PMC

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