Uncombable Hair Syndrome

Abstract

A 4-year-old boy was noted to have unruly, spangled hair, which could not be combed flat. His mother reported that his hair had always had that texture and that it seemed to grow slowly. A hair pull test demonstrated that hairs could not be easily extracted, and light microscopic examination of the hair revealed pathognomonic characteristics of uncombable hair syndrome, including a triangular cross-sectional shape and canal-like longitudinal depressions.

Uncombable hair syndrome

“…14 Hair growth rates can be decreased or normal 12,15 ; hair shafts usually can not be extracted easily by a hair pull test. 16 This malformation is limited to the scalp hair, and hair is often of normal quantity and length. 14 It is never twisted, 3 and is not fragile or brittle.…”

“…14 Loose anagen hair syndrome in combination with UHS has also been reported. 16 It is important to note that other syndromes can mimic UHS clinically, such as Rapp-Hodgkin syndrome, and loose anagen hair syndrome. 12 In a recent study by Smith et al 10 that examined morphological hair abnormalities using light microscopy, a sample from the neurologically impaired group showed characteristic findings of UHS along with mental retardation, calcification of the basal ganglia, and coarse hair persisting beyond 8 years of age.…”

Adolescent girl with frizzy hair knotted in a bundle

“…The abnormality usually affects all scalp hair, although localized cases or partial UHS have been described . The hair is usually normal in quantity and length, with decreased or normal growth rates, and is difficult to extract via hair pull test …”

Hair That Is Difficult to Manage in a Hispanic Girl

“…Differential diagnoses include pili torti, monilethrix, acquired progressive kinking of the hair, drug-induced kinking, loose anagen syndrome, wooly hair, Hutchinson-Gilford progeria, and Marie Unna hereditary hypotrichosis or anhidrotic ectodermal dysplasia [3,8]. …”