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Year : 1993  |  Volume : 59  |  Issue : 4  |  Page : 201-202

Hair casts

Correspondence Address:
D M Thappa

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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

How to cite this URL:
Thappa D M, Kumar V, Sharma R C, Lal S. Hair casts. Indian J Dermatol Venereol Leprol [serial online] 1993 [cited 2020 Sep 24];59:201-2. Available from:

  Introduction Top

Grindon in 1897 [1] described this entity under the heading of "Ecbolic folliculitis" which was named as "Hair casts" by Kligman. [2] There are only 32 cases described in the literature so far [3],[6] Hence, we are reporting a case, for its rarity and diagnostic problem.

  Case Report Top

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 Top

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 [4],[6].It may be the result of root sheath covering extending beyond the normal limits of hair follicle. [6] Casts can be easily slid along the hair shaft. This characteristic is paramount in its diagnosis [2] 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, [6],[7] no such association was observed by us.

We observed three layers in the hair casts contrary to Kligman [2] who noted only two layers. This might be probably, due to different composition of hair casts as suggested by Scott and Roenigk. [7]

  References Top

1.Grindon J. A peculiar affection of the hair­follicle. J Cutan Genitourin Dis 1897 ; 15 256-9.  Back to cited text no. 1    
2.Kligman AM. Hair Casts. Arch Dermatol 1957; 75 509-11.  Back to cited text no. 2    
3.Brunner MJ, Facq JM. A pseudoparasite of the scalp hair. Arch Dermatol 1957; 75: 583.  Back to cited text no. 3    
4.Scott M. Peripilar keratin casts. Arch Dermatol 1959; 75: 654-5.  Back to cited text no. 4    
5.Bowyers A. Peripilar keratin casts. Br J Dermatol 1974; 90 : 231-2.  Back to cited text no. 5    
6.Fabbri P, Difonozo EM, Palleschi GM, Pacini P. Hair casts. Int J Dermatol 1988; 27 : 319-21.  Back to cited text no. 6    
7.Scott MJ, Roenigk HH. Hair casts classification, staining characteristics and differential diagnosis. J Am Acad Dermatol 1983; 8: 27-32.  Back to cited text no. 7    


[Figure - 1]


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