|Year : 1993 | Volume
| Issue : 4 | Page : 201-202
DM Thappa, Vijay Kumar, RC Sharma, S Lal
D M Thappa
Source of Support: None, Conflict of Interest: None
A case of hair casts in a 3-year-old girl is reported for its rarity and diagnostic dilemma.
Keywords: Hair cast
|How to cite this article:|
Thappa D M, Kumar V, Sharma R C, Lal S. Hair casts. Indian J Dermatol Venereol Leprol 1993;59:201-2
| Introduction|| |
Grindon in 1897  described this entity under the heading of "Ecbolic folliculitis" which was named as "Hair casts" by Kligman.  There are only 32 cases described in the literature so far , Hence, we are reporting a case, for its rarity and diagnostic problem.
| Case Report|| |
A 3-year-old girl born of a nonconsanguineous marriage was referred from paediatric clinic with a diagnosis of pediculosis capitis. The mother had noticed nit like formations on the scalp hair since birth. Endeavour to remove them manually was not successful. Other family members ware not affected by similar disorder.
On naked eye examination, the scalp hairs, predominantly over the occiput were found to be encircled by multiple, whitish, tubular structures, 2 to 8 mm long covering 2 to 3 cm of hair shaft of each hair from proximal end. These structures were fragile and were movable along the hair shaft. There was no hair loss, scaling or any other abnormality.
On light microscopy, these tubular structures were cylindrical in shape and comprised of three layers [Figure - 1].
During a period of 6 months follow up, patient did not improve with Cetavlon shampoo, coal tar salicylic acid ointment and even shaving of scalp hair was not effective.
| Comments|| |
Hair casts, a rare disorder, is characterised by fine white amorphous keratinous cylindrical structures of variable sizes and number that encircle the hair shaft at varying intervals from the scalp surface ,.It may be the result of root sheath covering extending beyond the normal limits of hair follicle.  Casts can be easily slid along the hair shaft. This characteristic is paramount in its diagnosis  and helps in differentiating it from other scalp disorders-nits of pediculosis capitis, piedra, trichomycosis, trichonodosis and trichorrhexis nodosa.
Although a few cases have been observed in conjunction with psoriasis, pityriasis simplex, seborrhoeic dermatitis, trichotillomania, lichen simplex, lichen spinulosus and following use of hair lacquer, , no such association was observed by us.
We observed three layers in the hair casts contrary to Kligman  who noted only two layers. This might be probably, due to different composition of hair casts as suggested by Scott and Roenigk. 
| References|| |
|1.||Grindon J. A peculiar affection of the hairfollicle. J Cutan Genitourin Dis 1897 ; 15 256-9. |
|2.||Kligman AM. Hair Casts. Arch Dermatol 1957; 75 509-11. |
|3.||Brunner MJ, Facq JM. A pseudoparasite of the scalp hair. Arch Dermatol 1957; 75: 583. |
|4.||Scott M. Peripilar keratin casts. Arch Dermatol 1959; 75: 654-5. |
|5.||Bowyers A. Peripilar keratin casts. Br J Dermatol 1974; 90 : 231-2. |
|6.||Fabbri P, Difonozo EM, Palleschi GM, Pacini P. Hair casts. Int J Dermatol 1988; 27 : 319-21. |
|7.||Scott MJ, Roenigk HH. Hair casts classification, staining characteristics and differential diagnosis. J Am Acad Dermatol 1983; 8: 27-32. |
[Figure - 1]