Thick, Adherent, Asbestos-Like and Overlapping Scales Encircling the Tufts of Hair Shafts in a 13-year-old Girl

Our plain-English summary of Thick, Adherent, Asbestos-Like and Overlapping Scales Encircling the Tufts of Hair Shafts in a 13-year-old Girl, by P. Kumar, B. Chowdhary, V.K. Mahajan (Indian Dermatology Online Journal, 2020).

The study

• Authors: P. Kumar, B. Chowdhary, V.K. Mahajan
• Journal: Indian Dermatology Online Journal
• Published: 2020;11(5):866-868
• Read it: PubMed · Publisher · Free full text

In plain English

This article is a single case report from a dermatology quiz series. It is not about asbestos exposure: "asbestos-like" in the title describes how the scalp scales looked, and the scalp condition is called pityriasis amiantacea. The authors described a 13-year-old girl in India who had thick, yellowish, overlapping scales binding tufts of hair across her scalp for 4 years. For 2 years she also had dry brownish-red bumps along her scalp margins and above her left collarbone. Microscopy showed no fungal elements. A skin biopsy showed features consistent with Darier's disease, an inherited skin disorder. Her skin lesions resolved and the scalp scaling decreased 4 weeks after treatment with oral isotretinoin, a ketoconazole shampoo and a steroid-salicylic acid scalp lotion. The isotretinoin dose was lowered because of severe cheilitis (lip inflammation). A later flare was treated successfully with the antibiotic cefadroxil. She did not continue follow-up. The authors concluded that Darier's disease presenting as pityriasis amiantacea is extremely rare and that the link between the two conditions is not clear.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (Skin India Quiz)
• Who was studied: One 13-year-old girl with scalp lesions for 4 years, reported by dermatologists at Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
• Exposure: No asbestos exposure was studied. "Asbestos-like" describes the appearance of the scalp scales in pityriasis amiantacea.
• Main results:
  • Microscopy of potassium hydroxide (KOH) mounts showed no hair shaft abnormality and no fungal elements
  • Biopsy findings were consistent with Darier's disease, and the diagnosis was Darier's disease presenting as pityriasis amiantacea
  • Skin lesions resolved and scalp scaling decreased 4 weeks after treatment that included oral isotretinoin 20 mg once daily
  • The isotretinoin dose had to be decreased because of severe cheilitis
  • A later flare-up was treated successfully with oral cefadroxil, and the patient did not continue follow-up
• The authors' conclusion: The authors concluded that Darier's disease presenting as pityriasis amiantacea is extremely rare. They wrote that the causal relationship between the two is not clear, but that an exaggerated inflammatory response to Darier's disease or repeated pyogenic infection seems the most plausible explanation.

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