Schauder S1, Schwartz P2
Department of Dermatology1, Department of Anatomy2, University of Göttingen, Germany

Loose anagen hair syndrome is a sporadic or familial hair disorder that primarily affects children but may occasionally be seen in adults. The condition is due to defective anchorage of the hair shaft to the follicle, resulting in easily and painlessly pluckable hair. Patients complain of slow growing hair and diffuse or patchy alopecia. Diagnosis is based on microscopic and/or scanning microscopic identification of typical loose anagen hair that is devoid of sheets. From 1995 to 2005 we have seen 14 blond children aged 2 to 10 years who have been diagnosed as having loose anagen hair syndrome based on clinical and (scanning) microscopic features. None of the parents or siblings had a history of this disorder. Twelve of the patients were female. The age of onset was early childhood between 2 months and 3 years. Nine individuals had obvious sparse hair. Bald patches were found in 6 children whose hair was pulled out in tufts by a twin brother, a younger sibling or by children in preschool, respectively. One girl had unruly hair varying in hair length. All parents complained that their childrens' hair did not grow normally. The hair was pulled out easily and painlessly. Light microscopy of pulled hair showed misshapen hair bulbs and absent external root sheaths. Ruffling of the cuticle resembling a fallen sock was present only on a short segment of the proximal shaft. Scanning microscopy showed in addition ridged and fluted shafts. One girl presented because of tinea capitis from Microsporum canis. After the mycosis had been treated successfully, loose anagen hair syndrome was discovered. All parents were informed on the nature of this hair disorder. They were advised to keep their children away from hair pulling other children. Gently combing of the hair and a hair style without traction was recommended.