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Year : 2014  |  Volume : 1  |  Issue : 2  |  Page : 96-97

White spotted beard: A case of acquired trichorrhexis nodosa

Department of Dermatology, Father Muller Medical College, Mangalore, Karnataka, India

Date of Web Publication18-Dec-2014

Correspondence Address:
Srinath M Kambil
Department of Dermatology, Father Muller Medical College, Mangalore, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2349-6029.147316

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How to cite this article:
Kambil SM. White spotted beard: A case of acquired trichorrhexis nodosa. Indian J Dermatopathol Diagn Dermatol 2014;1:96-7

How to cite this URL:
Kambil SM. White spotted beard: A case of acquired trichorrhexis nodosa. Indian J Dermatopathol Diagn Dermatol [serial online] 2014 [cited 2022 Jan 24];1:96-7. Available from: https://www.ijdpdd.com/text.asp?2014/1/2/96/147316


Trichorrhexis nodosa (TN) is a hair shaft disorder characterized by fragile hair with nodes on the hair shaft. It may be congenital or occurs secondary to physical and chemical trauma. [1]

A 20-year-old man presented with 3 months history of white spots on his beard hair and these hair were breaking off at the site of white spots. He gave history of frequent brushing of his beard hair, about 5-6 times a day. There was no history of bleaching, using hair cosmetics, or hair straightening. No similar lesions were seen on scalp hair or other hairy sites. There was no history suggestive of systemic illness or similar complaints in the family. Clinical examination revealed white nodes on the distal part of the hair shaft of the beard area [Figure 1]. Differential diagnoses considered were acquired trichorrhexis nodosa and white piedra. Light microscopy of the hair showed fraying of cortical fibers giving the appearance of two paint brushes thrust together [Figure 2]. This finding was suggestive of TN.

Congenital TN may occur as an isolated autosomal dominant defect or may be associated with disorders like argininosuccinic aciduria, Menkes's kinky hair syndrome, and trichothiodystrophy. [2],[3] Acquired TN occurs due to repetitive trauma resulting from excessive brushing, back combing, application of heat, shampoo, dyes, and bleaching, and prolonged exposure to ultraviolet light. [4],[5] Light microscopy of the hair reveals cortical fiber fraying giving a "thrust paint brushes appearance." Treatment is prevention of repetitive physical and chemical insults to the hair. [1],[6]

  References Top

Martin AM, Sugathan P. Localised acquired trichorrhexis nodosa of the scalp hair induced by a specific comb and combing habit-a report of three cases. Int J Trichology 2011;3:34-7.  Back to cited text no. 1
Kharkar V, Gutte R, Thakkar V, Khopkar U. Trichorrhexis nodosa with nail dystrophy: Diagnosis by dermoscopy. Int J Trichology 2011;3:105-6.  Back to cited text no. 2
Fichtel JC, Richards JA, Davis LS. Trichorrhexis nodosa secondary to argininosuccinicaciduria. Pediatr Dermatol 2007;24:25-7.  Back to cited text no. 3
Ghorpade A. Moustache twirler's trichorrhexis nodosa. J Eur Acad Dermatol Venereol 2002;16:296-7.  Back to cited text no. 4
Mirmirani P. Ceramic flat irons: Improper use leading to acquired trichorrhexis nodosa. J Am Acad Dermatol 2010;62:145-7.  Back to cited text no. 5
Martínez de Lagrán Z, González-Hermosa MR, Díaz-Pérez JL. Localized trichorrhexis nodosa. Actas Dermosifiliogr 2009;100:522-4.  Back to cited text no. 6


  [Figure 1], [Figure 2]


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