Loose Anagen Syndrome

    November 2019
    Luke Maxfield, Christopher Cook
    TLDR Loose anagen syndrome causes easy hair shedding in children, often resolving on its own.
    Loose anagen hair syndrome (LAS) was a condition characterized by non-scarring alopecia and increased hair shedding due to poorly anchored anagen hairs, most commonly affecting female children. It was inherited in an autosomal dominant fashion with incomplete penetrance or occurred sporadically. The condition presented with diffuse thinning and unruly hair that was easily and painlessly removed. Diagnosis could be confirmed with a hair pull test and light microscopy showing a deformed anagen bulb, absent inner root sheath, and ruffled cuticle. Histopathologic exams revealed premature and defective keratinization of the inner root sheath. While most cases resolved spontaneously, topical minoxidil was recommended as first-line therapy for infants and children.
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