An objective measurement of the anchoring strength of anagen hair in an adult with the loose anagen hair syndrome

Abstract

A 21-year-old male presented with the life-long symptom of slowly growing, easily extractable hair lacking sheath remnants. The distribution and density of all his hair regions appeared normal and there was no alopecia. A hair-pull test was painless and resulted in all hairs being removed, all in keeping with a diagnosis of loose anagen hair syndrome (LAHS). The trichogram was normal. Electronically measured epilation revealed values which were significantly lower than controls. His hair follicles were remarkable for this syndrome in that they looked perfectly normal with light microscopy; however, the segment of the follicle with the keratogenous zone was significantly shorter than normal. It is postulated that a subtle intercellular defect must reside in the line of shear proximal to the level of cuticular differentiation to account for the weak anchoring of the root in the follicle. A consequence of a genetic error probably causes both the weak anchoring and the slow hair growth.