is a hereditary disease characterized by:
spindle swelling of the hair
fragility of the hair .
(twisted hair) :
mainly children and is characterized by :
hair shaft with thickened and thin areas .
are arranged irregularly on the hair shaft .
the shaft at the sites of the nodes.
shaft shows nodes in the form of balls at the distal part of the
shaft and sockets at the proximal part of the shaft .
appears segmented by light and dark color .
kinking of the hair shaft .
Fig. 426 b Abnormalities of hair growth
hairs emerging from the same follicle with a common outer root
nodules of different colors on the hair shaft affecting the axilla
and pubic areas in adults.
is an inflammation of the hair follicles that may be due to
bacterial or fungal infections.
may be superficial or deep .
folliculitis : small
pustules surrounded by an erythematous zone develop near the
follicular orifice .
pustules connected by a narrow channel with a deep abscess. Deep
folliculitis may leave scarring after healing . Infection is usually
caused by Staphylococci predisposed by severe itching and
excoriation of skin and mild trauma.
De calvans is an inflammation of the fair follicles ending by
mainly children in epidemics .
Fig. 426. Folliculitis
affected are mainly the back of the neck and shoulders.
macules and follicular papules become generalized appear in a short
time accompanied with mild constitutional symptoms such as fever.The
follicular papules may resemble keratosis piliaris .
Fig. 427. Folliculitis
Fig. 428. Cicatriial Alopecia & Folliculitis
(Hyperkeratosis Follicularis )
characterised by follicular hyperkeratosis , which forms a horny
corn ,leaving a pit when removed .
affected are the lower limbs .
of the follicular papules may form different shapes such as
circinate or verrucous lesions.
scars may be seen after healing of lesions .
affects chiefly children.
filiform horny spines that protrude from the follicular openings.
lesions, symmetrically distributed over the trunk, limbs, buttocks,
neck, popliteal and extensor surfaces of the arms.
is primarily under close genetic factors. Enzyme degradation
products of melanosomes within matrix cells may cross cell membranes
to melanocytes and control further melanin production.
melanocytes are known to respond like epidermal melanocytes to
melanocyte stimulating hormone (MSH), which can darken light-colored
graying of hair has been defined as the onset of hair graying before
20 years of age in Caucasoid and 30 years of age in Negroid. It
probably has a genetic basis and occasionally occurs as an isolated
autosomal dominant condition.
Autoimmune diseases .
Book‘s syndrome: this is an autosomal dominant trait. The syndrome
is characterized by :
graying of hair.
Premature ageing syndromes: Progeria and Werner‘s syndrome .
progeria it is associated with marked loss of scalp hair as early as
2 years of age.
spotting or partial albinism is an autosomal dominant abnormality
with patches of skin totally devoid of pigment, which remain
unchanged throughout life. Most commonly, a frontal white patch
occurs - the white forelock - which may be the only sign.
Fig. 429. Piebaldism
associated with piebaldism
Loss of skin
and hair pigment.
syndrome is characterized by:
vitiligo and poliosis
eyebrows and eyelashes .
deafness is rarely associated.
hair may be the earliest sign .
neuro fibromatosis: café au lait macules, axillary, perineal
freckling, and cystic lesions.
malnutrition, such as in kwashiorkor, hair color changes which are
prominent features. Normal black hair becomes brown or reddish, and
brown hair becomes blonde.
may occur in vitamin B12 deficiency.
ulcerative colitis and after extensive bowel resection.
:Black hair may become brown.,
high concentrates of copper in industry or from inadvertently high
concentrations in tap water or in swimming pools may cause green
hair, particularly visible in blonde-haired subjects.
and Dithranol may cause yellowish hair.
shampoos are made from vegetable or animal fats that can remove dirt
and greases as efficiently as detergents . The ingredients contained
in the shampoos such as tar and many others may cause change of the
gels and fixatives of the hair may have also the same effect.
"hirsutism" and "hypertrichosis" includes excessive hair growth of any
type in any distribution. Newborn infants may have pigmented hair
covering the skin surface, which usually shed after few weeks. This
may be related to increased circulating androgens from the mother.
This type is of unknown origin that can affect any age even small
children and babies.
idiopathic hirsutism the concentration of plasma testosterone is
usually within or only slightly above the normal range;
androstenedione is more often found to be elevated . The sensitivity
of androgen receptors in the skin may be increased to androgen and
this is believed to be the cause of hirsutism in presence of normal
Fig. 430. Hirsutism
Fig. 431. Hirsutism
Fig. 432. Hirsutism
of the pituitary, adrenal and ovarian glands may produce hirsutism.
Cushing‘s syndrome and Stein Leventhal syndrome are associated
of facial, trunk and extremity hair in the male and of pubic and
axillary hair in both sexes is clearly dependent on androgens.
from the interstitial cells of the testis is responsible for growth
of beard and body hair in male adolescence.
differs in that its growth does not require any androgenic stimulus.
Increased androgens on the other hand may cause falling and
recession of hair in post pubertal males.
diffuse alopecia is androgenic. While it may be associated with
virilism and high androgen levels resulting from disorders of the
adrenal cortex or ovaries, plasma androgens are usually normal.
anomalies such as congenital hypertrichosis and Cornelia de Lange
syndrome. Hirsutism may appear early in children and young age.
hirsutism. This type is inherited and transmitted as an autosomal
dominant, where vellus hair may cover the entire skin surface except
the palms and soles, which are free of hair follicles.
hypertrichosis is associated in some areas besides hirsutism with
dental anomalies and gingival fibromatoses.
factors : Stress has
been blamed to cause hirsutism . Psychic trauma and emotional stress
in spite that it may cause falling of hair, it may cause hirsutism
in susceptible individuals. This may be related to the increased 17
ketosteroids in emotionally disturbed persons.
types of idiopathic hirsutism are familial running in families and
certain races especially dark skinned individuals.
may cause hirsutism
disorders: such, as
error of metabolism of porphyrins may be associated with hirsutism.
as giant and Becker‘s nevus may be associated with localized
drugs such as ACTH, corticosteroids, hexachlorobenzene,
Diphenylhydantoin and testosterone may induce hirsutism. The
response to testosterone depends on the testosterone receptors in
the skin and their sensitivity to the amount given.
ASSOCIATED WITH HIRSUITISM
syndrome the vellus hair becomes more pigmented .
bearded women syndrome
syndrome usually appears in diabetic females.
Facial changes include : Long eye lashes, excessive eyebrow hair,
facial blueness, saddle nose and high upper lip .
Hypoplastic genitals, nipple and umbilicus.
the cause .
ladies use an old traditional preparation of lemon and sugar heated
forming a paste which is applied to the hairy extremities or other
parts then this paste after some times is pulled from the skin
surface. This preparation is widely used and can get red of hair and
an easy and less expensive method.
especially if applied to sensitive areas of the body.
that this can give a very clean skin surface from hairs, it leaves
ecchymotic areas, which after healing may leave some pigmentation.
growing hair under the skin surface and papular rough surface .
the hair: This is
also a simple method .It can give good satisfactory results
especially if shaving is applied from up and down and not to reverse
the direction of shaving where this may lead to coarse, thick more
pigmented hair after regrowth.
Different types of lasers are available recently which cause
destruction of hair follicles and can get rId of unwanted hair on
the chin and the body . This method is safe , effective but is more
HP. Hair keratin. In: Orfanos CE, Happle R, eds. Hair and Hair
Diseases. Berlin: Springer-Verlag, 1990: 45-71.
U, Ferracin J, Verschoore M et al. Physiology of the vellus
follicle: hair growth and sebum excretion. Br J Dermatol 1991;
JF, Menkart T. Hair coloring. Cutis 1973; 12: 190-5.
FJG, Hale PA, Randall VA. Hormones and hair growth. In: Goldsmith
LA, ed. Biochemistry and Physiology of the Skin 2nd edn. Oxford:
Oxford University Press, 1991.
FJ, Johnson E. The control of hair growth. Symp Zool Soc Lond
1964; 12: 97-130.
FJG, Randall VA. Hormonal actions on hair follicles and associated
glands. In: Skerrow D, Skerrow CJ, eds. Methods in Skin Research.
New York:Wiley, 1984: 297-327.
Editorial. Endocrine treatment in hirsutism. Br Med J 1975; ii:
Forslind B. The growing anagen hair. In: Orfanos CE, Happle R,
eds. Hair and Hair Diseases. Berlin: Springer-Verlag, 1990: 73-97.
Hamilton JB. Age, sex and genetic factors in the regulation of
hair growth in man: a comparison of Caucasian and Japanese
populations. In: Montagna W, Ellis RA, eds. The Biology of Hair
Growth. New York: Academic Press, 1958: 399-433.
Kalopesis G. Toxicology and hair dyes. In: Zviak C, ed. The
Science of Hair Care. New York: Marcel Dekker Inc, 1986.
E. Classification of the types of androgenic alopecia (common
baldness) arising in the female sex. Br J Dermatol 1977; 97:
Norwood O‘TT. Male pattern baldness. Classification and
incidence. Southern Med J 1975; 68: 1359-70.
Norwood O‘TT. Male pattern baldness. Classification and
incidence. Southern Med J 1975; 68: 1359-70.
GF. Structure of the skin. In: Goldsmith LA, ed. Biochemistry and
Physiology of the Skin. Oxford: Oxford University Press, 1983:
Johnson E. Environmental influences on the hair follicle. In:
Orfanos CE et al. eds. Hair Research; Status and Future Aspects.
Berlin: Springer, 1981: 183-94.
Kligman AM. The human hair cycle. J Invest Dermatol 1959; 33:
Pecoraro V, Astore I, Barman JM et al. The normal trichogram in
the child before the age of puberty. J Invest Dermatol 1964; 42:
Pecoraro V, Astore I, Barman JM. Cycle of the scalp hair of the
new-born Child. J Invest Dermatol 1964; 43: 145-7.
A, Dawber R, eds. Diseases of the Hair and Scalp 2nd edn. Oxford:
Blackwell Scientific Publications, 1991.
S?alamon T. Genetic factors in male pattern alopecia. In:
Baccaredda-Boy A, Moretti G, Frey JR, eds. Biopathology of Pattern
Alopecia. Basle: Karger, 1968: 39-56.
Moynahan EJ. Familial congenital alopecia. Proc Roy Soc Med 1962;
McKnight E. The prevalence of ‘hirsutism‘ in young women.
Lancet 1964; i: 410-12.
Ortimer CH, Rushton H, James KC. Effective medical treatment for
common baldness in women. Clin Exp Dermatol 1984; 9: 342-8.
EA, Delong ER, Weiner MS. Long-term follow-up of men with male
pattern baldness treated with topical minoxidil. J Am Acad
Dermatol 1987; 16:688-95.
EA, Weiner MS, Amara LA et al. Five year follow-up of men with
androgenetic alopecia treated with topical minoxidil. J Am Acad
Dermatol 1990;22: 643-9.
Burnett CM, Corbett JF, Lanman BM. Hair dyes and aplastic anaemia.
Drug Chem Toxicol 1978; 1: 45-7.
Rabinowitz S, Cohen R, Le Roith D. Anxiety and hirsutism. Psychol
Reports 1983; 53: 827-33.
G. The regional frequency and distribution of hair follicles in
human skin. In: Montagna W, Ellis RA, eds. The Biology of Hair
Growth. New York: Academic Press, 1958: 33-8.
Wickett RR. Permanent waving and straightening of hair. Cutis
1987; 39: 496-500.
C, Bouillon C. Hair treatment and hair care products. In: Zviak C,
ed. The Science of Hair Care. New York: Marcel Dekker Inc, 1986.
||Kaufman KD, Olsen EA,
Whiting D, Savin R, DeVillez R, Bergfeld W, et al.
Finasteride in the treatment of men with androgenetic
alopecia. J Am Acad Dermatol 1998; 39: 578-589
||Sinclair R. Male pattern
androgenetic alopecia. BMJ 1998; 317: 865-869
||Sawaya ME, Price V.
Different levels of 5-reductase
type I and II, aromatase, and androgen receptor in hair
follicles of women and men with androgenetic alopecia. J
Invest Dermatol 1997; 109: 296-300