Acquired Progressive Kinking of the Hair in a Prepubertal Boy

In 1997, a case of Acquired Progressive Kinking of the Hair (APKH) was reported in a 10-year-old prepubertal boy, marking the earliest onset in males and the first in a prepubertal male to date. The boy presented with tufts of dull, coarse, hyperpigmented, kinky hair on the scalp, without any history of illness, trauma, or treatment that could explain the condition. Clinical examination and microscopy confirmed the kinking of the hair shafts. Over a 12-month period, the affected area increased in size but eventually returned to normal without intervention. APKH typically presents after puberty and is characterized by patches of curly hair that are darker and coarser than unaffected hair. The condition is often progressive, but non-progressive cases have been reported, suggesting a broader term of "acquired kinking of the hair" may be more appropriate. The cause of APKH is unknown, but it may be related to hormonal changes or genetic factors, as it sometimes progresses to male-pattern baldness. Differential diagnosis includes other hair disorders, but APKH is distinct in its presentation and progression. The case suggests that APKH in prepubertal individuals may represent a distinct variant of the condition.