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Special Feature
December 06, 2010

Picture of the Month—Quiz Case

Author Affiliations
 

SAMIR S.SHAHMD, MSCE

Arch Pediatr Adolesc Med. 2010;164(12):1165. doi:10.1001/archpediatrics.2010.228-a

A 9-year-old white boy presented with unruly hair since birth. Although his hair appeared to have normal growth without excessive loss or increased brittleness, it did not maintain its shape after styling. His older sister had experienced similar hair problems during childhood (Figure 1) but the condition had disappeared spontaneously with puberty. The hair of the other immediate family members was normal. On examination we observed the patient's entire scalp was covered with yellowish, dry, frizzy hair that projected outward and resisted any attempt to flatten it (Figure 2and Figure 3). The results of the rest of the clinical examination were unremarkable. On dermoscopy and electron microscopy (×10 and ×600 original magnification, respectively), a longitudinal grooving and a triangular shaft were found in examined hairs (Figure 4and Figure 5).

Figure 1.
Our patient, at 3 years old, with his 7-year-old sister. Unusually frizzy blond hair is present in both siblings but to a lesser extent in the sister.

Our patient, at 3 years old, with his 7-year-old sister. Unusually frizzy blond hair is present in both siblings but to a lesser extent in the sister.

Figure 2.
Overview of the scalp of the patient at 9 years old, with yellowish, frizzy hair.

Overview of the scalp of the patient at 9 years old, with yellowish, frizzy hair.

Figure 3.
Close-up of the temporal region of the scalp of the patient at 9 years old, with dry, frizzy hair.

Close-up of the temporal region of the scalp of the patient at 9 years old, with dry, frizzy hair.

Figure 4.
Dermoscopy (×10 original magnification) showing multiple-directional growth and a longitudinal groove in the silvery hair in the middle of the image.

Dermoscopy (×10 original magnification) showing multiple-directional growth and a longitudinal groove in the silvery hair in the middle of the image.

Figure 5.
Electron microscopy analysis (×600 original magnification) showing the triangular hair shaft with longitudinal grooving.

Electron microscopy analysis (×600 original magnification) showing the triangular hair shaft with longitudinal grooving.

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