title: A new clinical disorder of twisted and rolled body hairs with multiple, large knots.
abstract: BACKGROUND
  We present a new hair disorder characterized by an unusual twisting and matting of body hairs. This disorder may occur as an acquired or, possibly, an inherited trait.
  
  
  OBJECTIVE
  Our purpose was to analyze the clinical features of three patients and report the changes revealed by light microscopy and scanning electron microscopy.
  
  
  METHODS
  We examined two unrelated adults with acquired multiple large knots of body hairs and a newborn infant with a familial history of the same entity.
  
  
  RESULTS
  In the two adults the hairs were rolled and knotted together, and twisting of body hairs occurred in areas where rubbing was frequent. In the familial type, which was suggestive of an autosomal dominant inheritance pattern, no mechanical explanation could be found. Light microscopy confirmed the clinical impression of twisted and felted hairs, and scanning electron microscopy revealed sticking of at least 20 hairs. No underlying skin disease or deeper process was found.
  
  
  CONCLUSIONS
  Multiple twisted and rolled body hairs that may develop into multiple, large knots may appear as a minor variant of hair matting or felting. Scanning electron microscopy shows multiple hairs that originate from different hair follicles and roll and stick together centrally.
authors.affiliation: Department of Dermatology, University of Basel, Switzerland.
authors.forename: P H
authors.initials: PH
authors.lastname: Itin
authors.forename: A J
authors.initials: AJ
authors.lastname: Bircher
authors.forename: S
authors.initials: S
authors.lastname: Lautenschlager
authors.forename: E
authors.initials: E
authors.lastname: Zuberbühler
authors.forename: R
authors.initials: R
authors.lastname: Guggenheim
mesh_terms: D000368:Aged; D005190:Family; D005260:Female; D006201:Hair Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D008405:Massage / Q000009:adverse effects; D008875:Middle Aged