With the recent advent of innumerable proprietary hair preparations, it is logical to expect that previously undescribed hair artifacts will be observed. It is important that unusual artifacts be reported and that physicians become acquainted with them to avoid possible confusion with other hair abnormalities.
Two such artifacts have recently come to my attention in several patients using hair sprays utilized to maintain hair position. One of these, piedra-like artifacts, has not previously been described. The second, peripilar keratin casts,1 also results from the external application of hair preparations. This latter condition was initially described as "A Pseudoparasite of the Scalp Hair" by M. J. Brunner and J. M. Facq2 and also as "Hair Casts" by A. M. Kligman.3 The former authors offered no comment regarding etiology, but Kligman believed the findings suggested a hereditary, sex-limited disorder.
Peripilar keratin casts are characterized by asymptomatic, minute, semi-firm, tannish,
SCOTT MJ. Piedra-Like Artifacts. Arch Dermatol. 1960;82(6):1003–1005. doi:10.1001/archderm.1960.01580060159028
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