Trichorrhexis

TRICHORRHEXIS nodosa (syn. trichoklasia, clastothrix, nodositas crinium, scissura pilorum), a disease of the hair, thoroughly described by Kaposi (1876). The hair is affected, mainly of the head, beard, and pubic region. Women with dry hair are more frequently affected. On the hair, grayish-white nodular formations are visible, which at a cursory examination give the impression of nits, but upon closer examination, these nodules turn out to be frayed hairs. When pulled, such hairs break at the sites of formation of these nodules, and the broken ends of the hairs appear frayed like a brush. On one hair, there can be up to 20 such nodular formations. Under the microscope, a ruptured hair cuticle and fraying of the cortical substance are visible. Of the existing four hypotheses attempting to explain the occurrence of T. nodosa (trophoneurotic, traumatic, hereditary, infectious), the traumatic and infectious hypotheses appear more substantiated. Traumatic factors include frequent washing with alkali impurities (borax, soda), the use of hard and especially sharp metal brushes for combing, etc. The prognosis is favorable, but the course is often prolonged. Frequent washing is prohibited, it is necessary to eliminate all hair-irritating factors, and to lubricate daily with fats (Ol. Ricini, Ol. Amygdalarum, Ol. Lini or others); in limited foci, manual epilation is indicated. Trichoptilosis, a peculiar affection of the hair, mainly of the head and beard, first described by Devergie (1872), consisting in the splitting of the peripheral ends of the hair; a picture resembling bird feathers is obtained. Men are affected somewhat more frequently. Two forms are distinguished: idiopathic and symptomatic (in trichophytosis, eczema, anemia, cachexia, gout, etc.). The etiology is unknown; one of the predisposing causes is excessive dryness of the hair. Treatment is as for T. nodosa.