Adult onset hair casts: Nits which do not itch!

Abstract

Hair casts (HCs) are thin, elongated, firm, whitish cylindrical concretions which ensheath the hair shaft and can be easily dislodge. They are of two different types: peripilar and parakeratotic keratin cast. Due to its clinical resemblance to pediculosis capitis, the entity is also known as pseudonits. Al though not unusual, false diagnoses are common, and thus, it is very important to correctly differentiate it from other similar conditions. We report here a case of HC involving scalp as well as body hair in association with androgenetic alopecia in a 22-year-old male patient. The patient's sister was also affected with pseudonits.