A 3-YEAR-OLD girl has had sparse hair since infancy and has never required a haircut. The scalp has been normal, except for minimal seborrheic dermatitis in early infancy. She has never had areas of complete hair loss, nor has she been noted to pull out her hair. Her health is excellent, and she is receiving no medications.
On physical examination, her hair was thin, blonde, and somewhat lusterless. Thinning was noted most prominently in the frontoparietal areas of the scalp (Figure 1). A patch of frizzy, kinked, unkemptappearing hair was noted at the vertex (Figure 2). The scalp was normal, as were the teeth, nails, and skin. Hair could be easily and painlessly pulled from the scalp. A light microscopic view of an epilated hair shows an abnormal anagen bulb (Figure 3). Figure 4 shows a normal anagen bulb.
DENOUEMENT AND DISCUSSION
LOOSE ANAGEN SYNDROME
CLINICAL MANIFESTATIONS
Loose