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Image Number 1076 (Trichorrhexis nodosa)

Hair loss diffuse

Diagnosis: Trichorrhexis nodosa

Site: Scalp

Sex: F

Age: 5

Type: Clinical

Description: Scarce, short, and easily broken scalp hairs.

Submitted by: Nameer Al-Sudany

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Differential Diagnosis


A 5-year old girl presented with sparse, short and easily-broken scalp hairs. The mother noticed the hair defect since early months of life. The skin, nails, teeth and mentality were normal. There was no family history of similar hair problem. Many hairs were plucked, mounted on a microscopic slide and carefully examined under the light microscope. Hair shaft fractures were seen with the hair ends at the fracture line look like two brooms stuck together.

The commonest hair shaft abnormality leading to hair breakage is trichorrhexis nodosa.  It may be congenital or acquired. In trichorrhexis nodosa complicating a congenital defect of the hair shafts (inherently weak hair), the hair breaks so easily that large or small portions of the scalp show only broken stumps and alopecia may be quite gross. Trichorrhexis nodosa may occur as an apparently isolated defect of the hair with node formation and hair shaft fractures are induced by minimal trauma and develop during the early months of life.


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