A Girl Struggling With Extremely Unruly Hair

    Christine Prodinger, Martin Laimer, Verena Ahlgrimm‐Siess
    TLDR The girl likely has Loose anagen hair syndrome, which may improve on its own or with minoxidil.
    A 9-year-old girl with lusterless, unruly hair that seldom required cutting was examined, revealing matte, shaggy hair on a normal scalp without tooth or nail abnormalities. Her hair pull test was positive, showing a predominance of anagen hairs (>80%). The girl's brother had similar hair, while her sister had normal hair growth. The most likely diagnosis was Loose anagen hair syndrome. Histopathologic changes included empty anagen follicles with infundibular pigment casts, hemorrhage, and trichomalacia adjacent to unaffected hair follicles. Spontaneous improvement was common, and minoxidil therapy might hasten resolution.
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