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Visual Treats in Dermatology
2021
:1;
64
doi:
10.25259/CSDM_69_2021

Nits that don’t itch

Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

*Corresponding author: Arunachalam Narayanan, Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. narayanan359@gmail.com

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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Narayanan A, Anas K. Nits that don’t itch. CosmoDerma 2021;1:64.

A 37-year-old male patient presented with asymptomatic, thin, tubular, whitish concretions ensheathing the hair shaft over the scalp [Figure 1a], moustache, axilla, and groin [Figure 1b] for 3 years. These concretions could be removed easily. Dermoscopic examination revealed multiple, cylindrical, and keratohyaline masses covering the hair shafts circumferentially [Figure 1c]. Based on the history, examination, and dermoscopic findings, we made a diagnosis of hair casts. Hair casts appear due to the faulty disintegration of the root sheath in the scalp hair, and rarely in the body hair. They may also be seen due to regular use of hair sprays or cosmetics.[1] Differentiating these hair casts from pediculosis capitis is essential for further management. The condition might respond to treatment with keratolytics, retinoids, or manual removal with comb.

(a) Thin, tubular, whitish concretions ensheathing the hair shaft over the occipital scalp. (b) Thin, tubular, whitish concretions ensheathing the hair shaft over the groin. (c) Dermoscopy showing multiple cylindrical, keratohyaline masses covering the hair shafts circumferentially.
Figure 1:
(a) Thin, tubular, whitish concretions ensheathing the hair shaft over the occipital scalp. (b) Thin, tubular, whitish concretions ensheathing the hair shaft over the groin. (c) Dermoscopy showing multiple cylindrical, keratohyaline masses covering the hair shafts circumferentially.

Declaration of patient consent

Patient’s consent not required as patients identity is not disclosed or compromised.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. , , , . Hair casts. Indian J Dermatol Venereol Leprol. 1993;59:201-2.
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