Low prevalence of twisted hair in anorexia nervosa

Abstract

In a series of 30 patients affected by severe anorexia nervosa (AN) we examined hair samples to detect the prevalence of acquired pili torti (APT). True APT were not detected but in two cases (6.6%) twisted hair was observed. The first case was a 24-year-old woman with secondary amenorrhoea for 9 years, whose body mass index (BMI) was 12.2 kg/m2. She also had severe skin xerosis and hypertrichosis. The second case was a 24-year-old woman with secondary amenorrhoea for 1 year, whose BMI was 11.3 kg/m2. She also had severe skin and lip xerosis, severe effluvium, cystic acne, acrocyanosis, perimylolysis (severe erosion of the dentition) and scars due to cigarette burns on her forearms. Reviewing the literature we noticed that the largest series of pili torti--congenital and acquired--were published by authors from countries such as Israel and Egypt. We therefore hypothesize that, under the same conditions, a genetic factor may predispose to this hair shaft defect.

Diseases of cutaneous appendages

“…512 Involvement of multiple hair-bearing sites and mental retardation are usually features of this variant. 622 Pili torti of early onset may improve with age. 621 It has also been reported in anorexia nervosa.…”

Hair Cortisol Concentrations in Adolescent Girls with Anorexia Nervosa are Lower Compared to Healthy and Psychiatric Controls

“…Secondary conditions of AN include cutaneous alterations, such as trophic disturbances of the hair follicle, for example acquired pili torti (Lurie et al, 1996) or twisted hair (Strumia, Borghi, Colombo, Manzato, & Gualandi, 2005). It cannot be excluded that such conditions may have resulted in a compromised incorporation of cortisol into the hair follicle of AN patients, thus resulting in artificially low cortisol concentrations.…”

Trichoscopy in genetic hair shaft abnormalities

“…30 Acquired pili torti have been reported after treatment with oral retinoids. 31 A localized form has been reported after trauma and in cicatrical alopecia. 30 Hair is often sparse, coarse, dry and fragile and affected persons frequently report that they have never required a haircut.…”