Hair Casts: A Clinical and Electron Microscopic Study

The study focused on hair casts observed in 22 girls aged 4 to 13, primarily affecting the frontal, vertex, and temporal areas of the scalp. The condition was linked to hairstyles like ponytails or pigtails, which 20 of the 22 girls wore, suggesting that tightly drawn braids might cause local circulatory disturbances and scalp inflammation, contributing to the disorder. Electron microscopy revealed large polymorphous scales and spores on the hair casts, and unique elements such as silicon, aluminum, and molybdenum were detected through energy-dispersive x-ray microanalysis. Compound root sheath casts were identified in some patients using a specific stain.