Posted January 24, 20205 yr Twin, w31+4, SGA 994g. Short time on ventilator/RDS and later CPAP. Now on HFNC. Now 6 weeks old. Since roughly 2 weeks age this girl has a patch of hypertrichosis in her scalp. This is surrounded by an area of slightly less hair. The patch has crusta-like borders so it feels like a scab. The dermatologist speculated a month ago of it being caused by the CPAP. It looks the same now after a month and I´m not familiar with wounds that has excessive hair growth in them? I´ve looked up "nevoid hypertrichosis" as an alternative diagnosis but of course a reaction after a wound is much more common... I have the parents consent to post the pics here Any ideas?
January 24, 20205 yr Hello, did you consider cranial imaging to rule out underlying scalp defect or intracranial communication? a
January 24, 20205 yr looking at Dr Asma Comment , Than why should it develop after 2 weeks ( if its a Neurocutaneous Marker)
January 24, 20205 yr Strange if nothing was seen from the start? Else I agree on that having nevioid lesions, lipomas or hemangiomas centrally etc one should rule out CNS-defects.
January 25, 20205 yr This could be an isolated localized hair overgrowth. However, it can be associated with neuroectodermal anomalies. CPAP has no relation to the hair tuft. Hair collar sign has been described. Below are some references. References 1. Commens C, Rogers M, Kan A. Heterotropic brain tissue presenting as bald cysts with a collar of hypertrophic hair: the ‘hair collar’ sign. Arch Dermatol. 1989;125(9):1253–1256 2. Drolet BA, Clowry L Jr, McTigue MK, Esterly NB. The hair collar sign: marker for cranial dysraphism. Pediatrics. 1995;96(2 pt 1):309–313 3. Stevens CA, Galen W. The hair collar sign. Am J Med Genet A. 2008;146A(4):484–487 4. Held I, Rose C, Hamm H, Fölster-Holst R. The hair collar sign: a possible indication of cranial dysraphism. J Dtsch Dermatol Ges. 2011;9(2):136–138 5. Bessis D, Bigorre M,Malissen N, et al;Groupe de Recherche Clinique en Dermatologie Pédiatrique. The scalp hair collar and tuft signs: a retrospective multicenter study of 78 patients with a systematic review of the literature. J Am Acad Dermatol. 2017;76(3):478–487 6. Harrington BC. The hair collar sign as a marker for neural tube defects. Pediatr Dermatol. 2007;24(2):138–140 An additional reference Alexander K.C. Leung and Benjamin Barankin. Visual Diagnosis: A Ring of Long, Dark, Coarse Hair on the Scalp of a 5-month-old Girl. Pediatrics in Review July 2018, 39 (7) e31-e32; DOI: https://doi.org/10.1542/pir.2017-0094
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