Itchy Black Hair Bristles on Back

A 27-year-old male presented with itchy black hair bristles on his inter-scapular region, diagnosed as trichostasis spinulosa (TS). TS is a common but often unrecognized disorder characterized by follicular hyperkeratosis and retention of telogen hairs. The exact cause is unknown, but factors like congenital dysplasia, external irritants, and microorganisms may contribute. Treatment is challenging, with options like emollients, keratolytics, retinoids, and depilation offering variable success. Permanent hair removal using lasers may provide a definitive cure. The case highlights the importance of recognizing the pruritic variant of TS and using trichogram for diagnosis.