Matchsticks On Dermoscopy = A Clue to Netherton’s Syndrome

Matchsticks On Dermoscopy = A Clue to Netherton’s Syndrome

‘Matchstick’ eyebrow hairs: a dermoscopic clue to the diagnosis of Netherton syndrome.

Goujon E, Beer F, Fraitag S, Hovnanian A, Vabres P.

J Eur Acad Dermatol Venereol. 2009 Oct 15.

• Netherton’s syndrome is an automal recessive skin condition (SPINK 5 frameshift mutations) caracterized by:

1. ichthyosiform erythroderma
2. ichthyosis linearis circumflexa
3. atopic dermatitis like features
4. hairshaft anomalies

• This short article highlights how dermoscopy helps in the diagnosis of Netherton’s syndrome by looking at the hair follicles. Indeed, those tend to be rarefied and microscopical examination doesn’t always enable to visualize the hair follicles.
• On clinical examination, bamboo hairs can be identified with a magnifying glass or dermscopy and this represents structurally trichorrhexis invaginata. Trichorrhexis invaginata represents the invagination of the distal portion of the hair shaft (“ball”) into the proximal (“socket”) portion of the hair shaft in a “ball and socket” fashion.
• This requires however an intact hair shaft junction and as this area is fragile the hair shaft distal to the “ball” or the “ball” + distal hair shaft can break off. These hairs are visible on the intact scalp as “matchstick” shaped or “golf tee” shaped hairs respectively.
• This might be helpful to note when complete hairshafts cannot be obtained.