Quiz on Trichology

A 12-year-old male child presented with multiple papular lesions over the body for 2 years. His mother gave history that he was born with normal hair which shed 2 months later and never regrown thereafter. Histopathology reveals multiple dermal cysts.^[1] What is your probable diagnosis?

A 5-year-old child presented with yellowish cup-shaped crusts having a mousy odour over the scalp for 2 weeks. Clinical diagnosis of tinea capitis was made. What is the characteristic microscopic appearance of the hyphae and the organism causing it?^[2]

A 50-year-old female presented with a papule with tuft of hair on the face for 6 months. Histopathology reveals a central dilated large follicle surrounded by multiple small follicles (Mamma and baby hairs), enveloped in an eosinophilic fibrous stroma.^[3] Identify the condition.

A 22-year-old male presented with patchy hair loss over the scalp for 3 months. Trichoscopy revealed irregularly arranged dilated follicular orifices without any features of alopecia areata, described as ‘Eastern pan cake sign’.^[4] What is your likely diagnosis?

A 43-year-old female presented with scarring alopecia over the frontal region of the scalp. UV-enhanced trichoscopy reveals fluorescence due to presence of follicular propionibacterium which indicates preservation of follicular unit viability and hence, better prognosis.^[5] What is the named sign and condition discussed here?

A 40-year-old male with androgenetic alopecia has been planned for follicular unit extraction. Fox test has been performed as a pre-procedure to assess the transection rates. Which grades of fox test have high transection rates?^[6]

A 40-year-old African woman presented with flesh-coloured, scarring alopecia over the vertex of scalp for 6 months with uterine leiomyomas. Histopathology showed perifollicular concentric fibrosis, premature desquamation of inner root sheath and eccentric thinning of follicular epithelium.^[7] What is your diagnosis?

What does the term ‘Trichodaganomania’ mean?^[8]

A 9-year-old girl was sent home from school because she had ‘lice’ on her head. On closer inspection, it is evident that the hair contains components that slide freely along the hair shaft.^[9] What is your most likely diagnosis?

Which gene is most likely mutated in a 10-year-old child with wooly hair, diffuse palmoplantar keratoderma and right ventricular arrhythmogenic cardiomyopathy?^[10]

What laboratory abnormality is commonly associated with familial alopecia areata?^[11]

A 8-year-old boy presented with atopy, icthyosis linearis circumflexa and anaphylaxis from food allergy. SPINK 5 gene mutation has been found.^[12] What is the characteristic hair abnormality in this patient?

A 35-year-old male is diagnosed to have androgentic alopecia and started on tablet dutasteride. What is your advise on blood donation after stopping the drug?^[13]

In trichotillomania, there is sparing of hair at periphery due to a lower pain threshold. This pattern of hair loss resembles the haircut of a mythical character in Robbin Hood.^[14] Name the sign which describes it.

A 7-year-old male child presents with sparse hair, pear-shaped nose and cone-shaped phalynx. There was a mutation in trichorhinophalangeal syndrome gene.^[15] What is your diagnosis?

Describe the hair finding in electron microscopy in a patient diagnosed with hypohidrotic ectodermal dysplasia.^[16]

A 15-year-old girl has been worried about the cosmetic appearance of red hair. What is the genetic abnormality that results in red hair?^[17]

A 11-year-old child presented with sparse hair, cleft palate, PPK and ankyloblepharon.^[18] Which syndrome is associated with these features?

A 25-year-old adult male is diagnosed with pseudofolliculitis barbae and trichoscopy reveals curved hair attached to skin on either sides.^[19] Name this trichoscopic sign.

A 13-year-old boy presented with slow-growing hair and patchy alopecia. He also had short, sparse and light-coloured hair. Trichogram showed more than 70% of anagen hairs. Electron microscopy revealed ruffled cuticle.^[20] Identify the condition.

Atrichia with papular lesions

Favic chandeliers (Knobby antler-like hyphae) seen in Trichophyton schoenleinii

Trichofolliculoma

Alopecic and aseptic nodules of scalp

Starry night sky sign seen in frontal fibrosing alopecia

Grades 4 and 5

Central centrifugal cicatricial alopecia

Compulsive hair biting

Hair casts

Plakoglobin (occurs in Naxos disease)

Thrombocytopenia

Trichorrhexis invaginata. The condition described here is Netherton syndrome

Avoid blood donation for 6 months.

Friar tuck sign

Trichorhinophalangeal syndrome

Longitudinal groove

Melanocortin 1 receptor

Hay-wells syndrome

Handlebar sign

Loose anagen hair syndrome