A Girl with Loose Anagen Hair Syndrome and Uncombable, Spun‐glass Hair

Abstract

A 4-year-old girl presented with a 2-year history of scalp hair that had an odd texture, was difficult to manage, tended to "stick out" from the scalp, and was irregular in length. A hair pull test revealed that hairs could be easily and painlessly extracted. Light microscopic examination of the hair demonstrated anagen hairs with a ruffled cuticle and distorted bulb as well as an unusual undulation and grooving of the shafts. These findings are consistent with both loose anagen and uncombable hair syndromes. The occurrence of both syndromes in the same patient seems unlikely, and we propose that our patient has loose anagen hair syndrome with features resembling uncombable hair syndrome.

Practical Guidelines for Evaluation of Loose Anagen Hair Syndrome

“…[1][2][3][4][5][6][7][8] In accordance with previous studies, 1,3,8,10-12 a large subset of patients had hair with an odd texture or hair that was difficult to comb, frizzy, or unruly. This texture difference is usually described as "sticky" or "matted" and is commonly located on the occipital scalp.…”

“…1 True uncombable "spun glass" hair and even woolly hair have been associated with LAHS. 8,17,18 Although many parents reported diffuse shedding of the hair or hair loss as their primary concern, none of our patients had clinically visible areas of complete hair loss, which can be a helpful sign in the narrowing of the differential diagnosis of nonscarring alopecia in children. Although LAHS is usually a condition limited to the scalp, the involvement of body hair and eyebrows has been reported in an adult patient with LAHS.…”

Light Microscopic Hair Abnormalities in Children: Retrospective Review of 119 Cases in a 10-Year Period

“…Rarely, juvenile cataract, ectodermal dystrophy, or LAHS are reported [14,15]. The color of the hair is typically blond or light brown, as was the case for the 6 children in our study.…”

Uncombable Hair Syndrome

“…If the microscopic characteristics of monilethrix, pili torti, and other classifiable genetic hair problems are not found, one can dismiss the disorders associated with these findings (7). Loose anagen hair syndrome mixed with features of uncombable hair syndome has been reported (9,10).…”