Monilethrix in Pattern Distribution in Siblings: Diagnosis by Trichoscopy

The document reported on two Indian male siblings, aged 24 and 21, diagnosed with monilethrix, a heritable hair shaft defect, and early-onset androgenetic alopecia. They exhibited progressive hair thinning and loss in a male pattern distribution, along with follicular keratosis. Trichoscopy revealed characteristic beaded hair shafts with uniform elliptical nodes and intermittent constrictions, confirming monilethrix. The study highlighted the utility of trichoscopy for rapid diagnosis and suggested that hair fragility from monilethrix might unmask androgenetic alopecia early. The diagnosis was confirmed through light microscopy, showing beaded hair with constrictions and fraying.