Clinical spectrum of woolly hair: indications for cerebral involvement

Ital J Pediatr. 2017 Nov 2;43(1):99. doi: 10.1186/s13052-017-0417-1.

Abstract

Background: Woolly Hair is an uncommon congenital anomaly of the scalp hair presenting with strongly coiled hair involving a localized area of the scalp or covering the entire side and occurring in non-black people. Isolated or localized wooly hair is usually benign and is not related to other disorders and/or complications. On the contrary, the generalized type may be related to disorders and syndromes affecting heart, cutis, liver and gastrointestinal organs. Among the syndromes presenting with wooly hair, the most known are the Naxos syndrome, the Carvajal-Huerta syndrome, the wooly hair/hypotrichosis, the ectodermal dysplasia-skin fragility, the tricho-hepato-enteric syndrome.

Case presentation: To our knowledge, no cases of wooly hair syndromes has been associated to neurologic involvement. Among the clinical notes of patients admitted in the Pediatric Units of the Catania University, we have selected four individuals presenting wooly hair, who showed different clinical features and course: case 1 presenting with a localized wooly hair type; case 2, member of a family affected by WH with autosomal dominant inheritance, not associated to complications; case 3, a wooly hair patient who displayed a progressive, severe form of Rasmussen's encephalitis with fatal evolution, and case 4, wooly hair associated to brain malformation and drug-resistant epilepsy.

Conclusions: With this report, we aim to underline the wide spectrum of clinical presentation of individuals with WH and in particular we wish to give an annotation on a possible association of WH with severe neurologic disorders.

Keywords: Epilepsy; Generalized; Localized; Rasmussen’s encephalopathy; Wooly hair.

MeSH terms

  • Cardiomyopathies / diagnosis*
  • Cardiomyopathies / genetics
  • Cardiomyopathy, Dilated
  • Child
  • Child, Preschool
  • Encephalitis / diagnosis*
  • Encephalitis / genetics
  • Female
  • Genetic Predisposition to Disease*
  • Hair Diseases / congenital*
  • Hair Diseases / diagnosis
  • Hair Diseases / genetics
  • Humans
  • Infant
  • Italy / epidemiology
  • Keratoderma, Palmoplantar / diagnosis*
  • Keratoderma, Palmoplantar / genetics
  • Male
  • Monitoring, Physiologic / methods
  • Prognosis
  • Rare Diseases
  • Risk Assessment
  • Sampling Studies
  • Severity of Illness Index
  • Syndrome

Supplementary concepts

  • Cardiomyopathy dilated with woolly hair and keratoderma
  • Woolly hair, congenital