International Journal of Trichology

CASE REPORT
Year
: 2016  |  Volume : 8  |  Issue : 1  |  Page : 24--25

Whisker hair (acquired progressive kinking of the hair): An indication for finasteride 1 mg?


Lorea Bagazgoitia, Sonsoles Aboín 
 Department of Dermatology, La Zarzuela Hospital, Madrid, Spain

Correspondence Address:
Lorea Bagazgoitia
La Zarzuela Hospital, Pleyades Street, 25. 28023, Madrid
Spain

Abstract

Acquired progressive kinking of the hair (APKH) and whisker hair are relatively rare conditions. To our knowledge, fewer than 25 cases have been reported in the English literature. We present the case of a 23-year-old man whose hair on the parietal and occipital areas changed and turned curlier and shorter. Patients suffering from APKH have higher risk of developing androgenetic alopecia and therefore finasteride 1 mg daily is proposed as an adequate treatment for these patients.



How to cite this article:
Bagazgoitia L, Aboín S. Whisker hair (acquired progressive kinking of the hair): An indication for finasteride 1 mg?.Int J Trichol 2016;8:24-25


How to cite this URL:
Bagazgoitia L, Aboín S. Whisker hair (acquired progressive kinking of the hair): An indication for finasteride 1 mg?. Int J Trichol [serial online] 2016 [cited 2019 May 22 ];8:24-25
Available from: http://www.ijtrichology.com/text.asp?2016/8/1/24/179391


Full Text

 Introduction



Aquired progressive kinking of the hair (APKH) and whisker hair are relatively rare conditions. To our knowledge, fewer than 25 cases have been reported in the English literature.

 Case Report



This blond, 23-year-old man referred that the hair around his ears and occipital area had turned darker, shorter, and curlier during the last 3 years. He also mentioned that the hair in that area was more scarce and fragile and was rather concerned about it. He had not taken any medications in the previous years nor had undergone any cosmetic procedures. No other people in his family showed similar changes on their hair. He referred no family history of androgenetic alopecia.

Clinical examination showed his normal blond, straight long hair on the frontal and parietal areas of the scalp, whereas the hair on temporal and occipital areas was brown, lusterless, short, and curly [Figure 1] and [Figure 2]. Traction test was negative.{Figure 1}{Figure 2}

 Discussion



APKH wasfirst described by Wise and Sulzberger in 1932.[1] APKH presents in young adults or children who show a change in texture and shape of the hair mainly on their frontotemporal areas. The hair turns coarse, curly, and lusterless. Changes in color have also been reported.

Whisker hair wasfirst reported by Norwood [2] in 1979. He reported a case of a patient with acquired short, curly hair, similar to that of beard on temporal and occipital areas. Whisker hair was included as a subtype of APKH by Mortimer et al. and Tosti et al.[3],[4] The cause of APKH and whisker hair remains unknown.

Differential diagnosis includes, on the one hand, familial woolly hair syndromes, woolly hair nevus and uncombable hair syndrome which are congenital and, on the other hand, diffuse partial woolly hair which is acquired. In the latter, the woolly hairs are distributed among normal hairs all over the scalp.

Cases of APKH and whisker hair in males have shown to be related to rapidly progressive androgenetic alopecia. All cases reported by Tosti et al. even if five of them were under treatment with topical minoxidil, developed androgenetic alopecia along the follow-up period (mean 4.5 years).[4] Higher concentrations of dihydrotestosterone [5] in the scalp as well as miniaturization of the hair follicle and a decreased anagen to telogen ratio [4] have been reported in these patients. Moreover, Norwood proposed that patients with whisker hair might not only develop normal androgenetic alopecia but would also loose the hair around his ears and occipital area, where the curly hair was previously.[6]

As in our case, patients with these conditions might suffer from psychological stress secondary to the change in the appearance of their hair. Therefore, it is important that dermatologist recognizes these entities so that they can warn the patients about the higher risk of developing androgenetic alopecia. At the time of the report of most of the cases of APKH and whisker hair, finasteride was not approved for androgenetic alopecia. Currently, finasteride 1 mg is considered an effective drug for preventing androgenetic alopecia, and patients suffering from APKH/whisker hair should be informed about it.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Wise F, Sulzeberg M. Acquired progressive kinking of the scalp hair accompanied by changes in its pigmentation. Arch Dermatol Syphilography 1932;21:99-110.
2Norwood OT. Whisker hair. Arch Dermatol 1979;115:930-1.
3Mortimer PS, Gummer C, English J, Dawber RP. Acquired progressive kinking of hair. Report of six cases and review of literature. Arch Dermatol 1985;121:1031-3.
4Tosti A, Piraccini BM, Pazzaglia M, Misciali C. Acquired progressive kinking of the hair: Clinical features, pathological study, and follow-up of 7 patients. Arch Dermatol 1999;135:1223-6.
5Boudou P, Reygagne P. Increased scalp skin and serum 5 alpha-reductase reduced androgens in a man relevant to the acquired progressive kinky hair disorder and developing androgenetic alopecia. Arch Dermatol 1997;133:1129-33.
6Norwood OT. Whisker hair – An update. Cutis 1981;27:651-2.