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Trichorrhexis nodosa - Hair and Scalp
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Trichorrhexis nodosa - Hair and Scalp

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Contributors: Mary Gail Mercurio MD, Jeffrey D. Bernhard MD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed

Synopsis

Trichorrhexis nodosa (TN) is a common congenital, familial, or acquired hair shaft defect that leads to fractured and easily broken hair. It is characterized by beaded swellings (nodes) with loss of cuticle. The condition appears clinically as small white nodes at irregular intervals along the hair shaft. The cortical fibers splay outward and fracture, giving the node the microscopic appearance of 2 brooms thrust together end to end. The typical expanded fracture or node precedes complete breakage.

The usual cause of TN is mechanical or chemical trauma, and it tends to be distal, where more weathering has occurred. Although TN occurs in normal hairs exposed to sufficient trauma, a contributory factor is an inherent weakness of the hair shaft. Structural hair abnormalities associated with increased fragility are subject to TN as a secondary event (eg, trichorrhexis invaginata, pili torti, monilethrix, pseudomonilethrix).

Acquired proximal TN is common in blacks, usually after years of harsh hair styling practices such as straightening, perms, combing, and other hair care practices. The lesions develop abruptly with resultant alopecia from widespread breakage. Distal trichorrhexis is also caused by repeated trauma and is more frequently seen in whites and Asians.

Pediatric Patient Considerations:
Congenital TN may occur alone or with other minor ectodermal abnormalities or in association with an underlying metabolic defect in the urea cycle such as argininosuccinic aciduria. In the case of argininosuccinic aciduria, these infants are usually systemically ill.

Codes

ICD10CM:
L67.0 – Trichorrhexis nodosa

SNOMEDCT:
238736006 – Trichorrhexis nodosa

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Last Updated: 01/20/2015
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Trichorrhexis nodosa - Hair and Scalp
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Trichorrhexis nodosa : Scalp, Unruly hair, Short broken hairs
Clinical image of Trichorrhexis nodosa
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