Spangled hair in siblings

Two north Indian siblings presented with severe atopic eczema and abnormal scalp hair, diagnosed as pili annulati, a rare non-fragile hair shaft disorder characterized by spangled hair due to banding. The condition is autosomal dominant and involves air-filled cavities in the hair shaft, visible as alternating light and dark bands under polarized microscopy. Pili annulati is not associated with alopecia and does not require treatment as the hair is non-fragile. The association with atopy is extremely rare, and further study of hair shaft abnormalities in atopic children was suggested.