Nits that don’t itch
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. 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.
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