Pili torti

Clinically, the hair of individuals with pili torti is dry, coarse, brittle, and fragile. It could lead to patchy alopecia. The most common area affected is the scalp, particularly the occipital and temporal regions. But the eyelashes, pubic hair, axilla, and eyebrows could also be affected. Typically, pili torti just impact a portion of the hair and do not alter the entire length of the hair. Occasionally, isolated pili torti might be discovered in a typical scalp. But it could be connected to a lot of regional and systemic issues. ==Causes==

Pili torti can be aqquired or inherited. Usually manifesting after puberty, late onset type is an autosomal dominant condition. People with dark hair seem to experience it more frequently. The hair twists in the late onset form are typically solitary, in contrast to the early onset kind. acrofacial dysostosis, Palagonia type, argininosuccinic aciduria, autosomal recessive ichthyosis with hypotrichosis, Bazex-Dupre-Christol syndrome, Björnstad syndrome, citrullinemia, congenital disorder of glycosylation, type Ia, congenital erythropoietic porphyria, congenital hypotrichosis with juvenile macular dystrophy, Conradi-Hünermann syndrome, Crandall syndrome, giant axonal neuropathy, hypotrichosis 6, Laron syndrome, Marie Unna hypotrichosis, McCune–Albright syndrome, Menkes disease, mitochondrial diseases, Netherton syndrome, occipital horn syndrome, Olmsted syndrome, peeling skin syndrome, Salti-Salem syndrome, steatocystoma multiplex, tricho-hepato-enteric syndrome, and trichothiodystrophy, photosensitive. A diverse range of hereditary diseases known as ectodermal dysplasias are defined by birth abnormalities in one or more ectodermal structures and associated appendages, such as the hair, teeth, nails, and sweat glands. There have been reports of pili torti in several ectodermal dysplasias, including ectodermal dysplasia with syndactyly, Basan syndrome, ectodermal dysplasia with corkscrew hairs, ectrodactyly, ectodermal dysplasia, and cleft lip/palate syndrome 3, Goltz syndrome, hidrotic ectodermal dysplasia, hypohidrotic ectodermal dysplasia, pachyonychia congenita-2, Rapp-Hodgkin syndrome, Reeds syndrome, Salamon syndrome, and trichodysplasia-xeroderma. Conditions associated with acquired pili torti include lichen planopilaris, frontal fibrosing alopecia, alopecia areata, central centrifugal cicatricial alopecia, discoid lupus erythematosus, dissecting cellulitis, folliculitis decalvans, pseudopelade of Brocq, linear scleroderma en coup de sabre, repetitive trauma, acne conglobate, anorexia nervosa, graft-vs.-host disease, hair transplantation, systemic sclerosis, oral retinoids, sodium valproate, and carbamide perhydrate. ==Mechanism==

Uneven growth of the outer root sheath cells is the source of hair twisting in hereditary forms. In acquired forms, the hair follicle is deformed and rotational forces are generated by a perifollicular inflammation followed by fibrosis. ==Diagnosis==

Examination under a microscope and trichoscope is used to diagnose pili torti. Low magnification trichoscopy in pili torti reveals the hair shafts bent at random intervals and at varied angles. At high magnification, the hair shaft's regular twists along its long axis are visible. Upon microscopic inspection, the shaft exhibits irregularly spaced clusters of three or four twists at random intervals. Classification Pili torti can be aqquired or inherited. There are three types of inherited pili torti: classic early onset (Ronchese type), late onset (Beare type), and pili torti linked to hereditary illnesses or disorders. Acquired pili torti may result from medication side effects or be linked to a variety of systemic and dermatological disorders. ==Treatment==

Pili torti does not have a specific treatment. It is advised to keep the hair from suffering damage. Additional techniques of care include dyeing, braiding, heat treatments, avoiding over-grooming, and sleeping on a satin pillowcase. After puberty, congenital pili torti may heal on their own. Drug-induced instances usually go away as the offending substance is stopped. The most crucial aspect of treating acquired pili torti is treating the underlying ailment. The use of pharmaceuticals to treat pili torti has minimal efficacy. Topical minoxidil has been proposed as a good therapeutic alternative for individuals with higher fragility in their hair shaft abnormalities. Nevertheless, it does not cause a causative treatment; rather, it solely affects hair density. ==History==

In 1932, Ronchese and Galewsky separately published the first descriptions of pili torti, also referred to as "twisted hair." ==See also==