L'ESAME DEI CAPELLI: UNA CHIAVE PER LA DIAGNOSI Ramon ...

ospedalebambinogesu.it

L'ESAME DEI CAPELLI: UNA CHIAVE PER LA DIAGNOSI Ramon ...

Ringing is only seen in pili annulatti. This shows a very characteristic bright and

dark bands when viewed by reflected light. The bright bands are caused by light

scattered from periodically occurring clusters of abnormal, air-filled cavities within

the hair. This condition may be sporadic or familiar in the latter cases usually with an

autosomal dominant pattern of inheritance. Etiology is unknown. Under the

microscope, the dark areas correspond to those seen as bright regions by reflected

light. Air-filled cavities do not permit light to pass through and therefore appear dark.

The denomination pseudo pili-annulati or pili pseudo-annulatti (13)has also been

used to describe normal hair with a strikingly banded appearance by reflected light.

The banding resulting to superficial optical effects stemming from the peculiar

geometry of the hair which might be elliptical in cross section and partially twisted in

an oscillating manner along the fiber axis.

Twisting is present in pili torti and in its variants. It might be clinically similar to pili

annulatti, because in both diseases, hair may shine under light. It is a rare hair-shaft

defect that when observed under the microscope, hair shows flattening and a

regular twisting along its longitudinal axis. The twists are narrow, occur in groups of

three to ten twists and give the hair a strikingly spangle appearance in reflected

light. The hair is always brittle, fragile, and consequently broken and short. Pili torti

is often misdiagnosed and can be also confused with monilethrix because an oval

fiber, when twisted, resembles one with variations in diameter when seen in a light

microscope. Different variants of pili torti have been described: Congenital pili torti or

classic pili torti (Ronchese) , late onset pili torti (Beare), corkscrew hair, pili torti with

cooper deficiency (Menkes) also called kinky hair, and the acquired pili torti in

cicatricial alopecia.

In conclusion, hair dysplasia in children can be easily oriented by the clinical

observation, and by learning the language of the hair shaft when viewed under the

microscope. Many diseases can be easily diagnosed by this extremely simple

examination method.

3

More magazines by this user
Similar magazines