Combing into trouble: localised acquired trichorrhexis nodosa

Area of Science:

• Dermatology
• Trichology
• Hair Shaft Disorders

Background:

• Trichorrhexis nodosa (TN) is a prevalent hair shaft abnormality.
• It presents as nodes along the hair shaft, leading to breakage.
• Acquired TN often results from external physical or chemical damage.

Purpose of the Study:

• To report a case of localized acquired TN in an adolescent.
• To identify a specific behavioral cause: repetitive friction from a plastic-bristled comb.
• To emphasize the diagnostic value of trichoscopy and microscopy.

Main Methods:

• Clinical examination of a teenage boy with scalp nodes.
• Trichoscopic evaluation revealing characteristic white nodules and 'paintbrush' appearance.
• Light microscopy confirming hair shaft structural abnormalities.

Main Results:

• Diagnosis of localized acquired Trichorrhexis nodosa confirmed.
• The cause identified as repetitive friction from a specific combing habit.
• Successful management through patient education and behavioral modification.

Conclusions:

• Trichoscopy and microscopy are crucial for diagnosing TN and differentiating it from other hair disorders.
• Behavioral factors, such as combing habits, are important etiological considerations in acquired TN.
• Modifying habits, like using a wide-toothed comb, is effective for managing TN.