Extract

Funding sources: none.

Conflicts of interest: none declared.

Dear Editor, An otherwise healthy 8‐year‐old girl with a ponytail hairstyle presented with asymptomatic whitish particles resembling nits attaching to the hair shaft close to the scalp (a, red arrows). Dermoscopy revealed white amorphous masses encircling the hair shaft (b, magnification × 50), which were able to slide up and down. The diagnosis of hair casts due to traction was made, and further confirmed by microscopy (c, magnification × 400) and scanning electron microscopy (d). Hair casts can be confused with head lice, as in our patient, or other hair shaft disorders.1 Dermoscopy and the ‘sliding hair casts’ sign allow an immediate and reliable diagnosis.

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