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Pili
torti
Pili torti is the common name but the same condition has also
been named trichokinesis and corkscrew hair. As the name suggests
pili torti is a twisting of hair fiber at focal points along its
length. There may be several twists in one hair fiber. The hair
cuticle is still intact but the twisting creates stress in the fiber
that leads to longitudinal fractures developing in the cuticle and
internal hair cortex. The twisting creates a weak point in the hair
fiber that can break. Twisted hairs can be found in people with
healthy hair and pubic hair is twisted in its normal state.
 Typically
scalp hair is most commonly affected in pili torti but the condition
can also be seen in eyebrow and eyelash hair as well as elsewhere
on the body in extreme cases. When hair twisting is frequently seen
in many scalp hairs, only then is it described as the distinct hair
condition pili torti. True congenital pili torti is most frequently
found in people with thin blond hair. However, twisting in scalp
hair can also occur in a wide range of hair diseases involving fiber
defects and brittle hair production.
Pili torti can be found in association with a range of congenital
conditions such as Bazex syndrome, Bjornstad's syndrome, menkes’
syndrome, Crandall’s syndrome, Beare’s syndrome, ichthyosis,
ectodermal dysplasias and many others. Conditions such as monilethrix,
woolly hair, and bamboo hair may also involve development pili torti
at times during the course of the condition.
Although most cases of pili torti are congenital in nature, occasionally
an individual may develop pili torti later in life. Areas of hair
follicles may begin to produce twisted hairs if the follicle are
disrupted in some way. Damage to the skin from burns or other forms
of scarring may result in damaged hair follicles and production
of pili torti hairs. Pili torti has also been noted in association
with anorexia nervosa and some drugs, especially retinoid drugs,
may promote pili torti. There are no treatments for pili torti but
sometimes the condition can improve spontaneously.
Pili
torti references
- Selvaag
E. Pili torti and sensorineural hearing loss. A follow-up of Bjornstad's
original patients and a review of the literature. Eur J Dermatol.
2000 Mar;10(2):91-7.
- Ansai S,
Mitsuhashi Y, Sasaki K. Netherton's syndrome in siblings. Br J
Dermatol. 1999 Dec;141(6):1097-100.
- Argenziano
G, Monsurro MR, Pazienza R, Delfino M. A case of probable autosomal
recessive ectodermal dysplasia with corkscrew hairs and mental
retardation in a family with tuberous sclerosis. J Am Acad Dermatol.
1998 Feb;38(2 Pt 2):344-8.
- Lurie R,
Danziger Y, Kaplan Y, Sulkes J, Abramson E, Mimouni M. Acquired
pili torti--a structural hair shaft defect in anorexia nervosa.
Cutis. 1996 Mar;57(3):151-6.
- Maruyama
T, Toyoda M, Kanei A, Morohashi M. Pathogenesis in pili torti:
morphological study. J Dermatol Sci. 1994 Jul;7 Suppl:S5-12.
- Herges
A, Stieler W, Stadler R. [Bazex-Dupre-Christol syndrome. Follicular
atrophoderma, multiple basal cell carcinomas and hypotrichosis].
Hautarzt. 1993 Jun;44(6):385-91.
- Abramovits-Ackerman
W, Bustos T, Simosa-Leon V, Fernandez L, Ramella M. Cutaneous
findings in a new syndrome of autosomal recessive ectodermal dysplasia
with corkscrew hairs. J Am Acad Dermatol. 1992 Dec;27(6 Pt 1):917-21.
- Moore CM,
Howell RR. Ectodermal manifestations in Menkes disease. Clin Genet.
1985 Dec;28(6):532-40.
- Hays SB,
Camisa C. Acquired pili torti in two patients treated with synthetic
retinoids. Cutis. 1985 May;35(5):466-8.
- Patel HP,
Unis ME. Pili torti in association with citrullinemia. J Am Acad
Dermatol. 1985 Jan;12(1 Pt 2):203-6.
- Silengo
MC, Davi GF, Bianco R, Costa M, DeMarco A, Verona R, Franceschini
P. Distinctive hair changes (pili torti) in Rapp-Hodgkin ectodermal
dysplasia syndrome. Clin Genet. 1982 May;21(5):297-300.
- Rogers M. Hair shaft abnormalities: Part
I. Australas J Dermatol. 1995 Nov;36(4):179-84; quiz 185-6.
- Telfer NR, Cutler TP, Dawber RP. The natural
history of 'dystrophic' pili torti. Br J Dermatol. 1989 Feb;120(2):323-5.
- Barth JH, Dawber RP. Pili torti and hirsuties:
are twisted hairs a normal variant? Acta Derm Venereol. 1987;67(5):455-7.
- Phillips ME, Barrie H, Cream JJ. Arginosuccinic
aciduria with pili torti. J R Soc Med. 1981 Mar;74(3):221-2.
- Dawber RP. Weathering of hair in monilethrix
and pili torti. Clin Exp Dermatol. 1977 Sep;2(3):271-7.
- Kurwa AR, Abdel-Aziz AH. Pili torti-congenital
and acquired. Acta Derm Venereol. 1973;53(5):385-92.
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