Light microscopic examination of scalp hair samples as an aid in the diagnosis of paediatric disorders: retrospective review of more than 300 cases from a single centre.
BACKGROUND
Microscopic examination of scalp hair can provide important diagnostic information in a range of paediatric conditions. It is a non-invasive and cost effective investigation, which is not widely performed.


OBJECTIVE
To examine retrospectively the value of hair examination by light microscopy, including polarising microscopy, in a specialist paediatric pathology department during a 15 year period (1989-2004) and to describe the morphological abnormalities indicative of specific paediatric conditions.


METHODS
Three hundred and twenty two hair samples were submitted. Microscopic changes were analysed in the light of clinical information categorised as: (1) erythroderma, (2) neurological impairment, (3) immunological/haematological defect, (4) ectodermal dysplasia, (5) abnormal hair only, and (6) non-specific/absent clinical details.


RESULTS
Abnormalities were evident in 49% of the samples. In 25%, the changes were compatible with specific diagnoses including Menkes disease, Netherton's syndrome, trichothiodystrophy, Griscelli and Chediak-Higashi syndromes, monilethrix, uncombable hair, and loose anagen syndromes. In respect of the clinical presentation groups noted above, diagnostic changes were seen in 41%, 32%, 33%, 0%, 29%, and 0%, respectively.


CONCLUSIONS
Morphological light microscopic examination of scalp hair is an inexpensive, rapid, and non-invasive investigation, which can provide valuable diagnostic information in a range of paediatric conditions.
Smith
V V
VV
Department of Histopathology, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.
Anderson
G
G
Malone
M
M
Sebire
N J
NJ
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004476:Ectodermal Dysplasia / Q000175:diagnosis; D006197:Hair / Q000002:abnormalities* / Q000473:pathology; D006201:Hair Diseases / Q000175:diagnosis* / Q000235:genetics; D006801:Humans; D016113:Ichthyosiform Erythroderma, Congenital / Q000175:diagnosis; D007223:Infant; D007231:Infant, Newborn; D007706:Menkes Kinky Hair Syndrome / Q000175:diagnosis; D009154:Mutation; D010784:Photomicrography; D012189:Retrospective Studies; D012535:Scalp / Q000473:pathology; D013577:Syndrome