Golf tee hairs in Netherton disease

We present a case of Netherton disease, where the hairs lacked the characteristic microscopic feature of trichorrhexis invaginata. In its place were certain hairs with a golf tee morphology. These represent the proximal half of the invaginate node seen in typical Netherton disease. Scanning electron microscopy demonstrated the three-dimensional quality of this abnormality, which is subtle when assessed by light microscopy alone. We describe this sign so that it might be recognized when seen in isolation, as here, and allow the diagnosis of Netherton disease to be confirmed.