Red hair heterochromia of the scalp
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Heterochromia of hair describes hair with 2 distinct colors in the same person. It can present in several distributions, namely patchy, segmental, diffuse, or following lines of Blaschko. Isolated hair heterochromia, a variant of pigmentary mosaicism, results from somatic gene mosaicism affecting hair follicles on the scalp in a Blaschkoid distribution and usually presents at birth or in infancy. We report a rare case of congenital red hair heterochromia following a line of Blaschko in a well infant and discuss the literature on scalp hair heterochromia. Heterochromia of hair describes hair with 2 distinct colors in an individual. It can present as patchy, segmental, diffuse, or in a Blaschkoid pattern.
Patchy hair heterochromia describes demarcated areas of hair color distinctly different to the patient's normal scalp hair. This dyschromia can appear as white, brown, or blond. Examples include patients with piebaldism or Waardenburg syndrome with a white forelock, poliosis in depigmenting conditions like vitiligo, and thicker and darker hair over congenital melanocytic nevi. Segmental hair heterochromia describes alternating light and dark sections in each hair shaft and may occur with iron deficiency. Diffuse scalp heterochromia describes hair of different colors evenly distributed over the entire scalp and may be associated with systemic conditions such as kwashiorkor or phenylketonuria with lighter hair color or with medications such as minoxidil causing hair darkening, diazoxide causing red hair, or chloroquine causing depigmented hair. Rarely, diffuse hair heterochromia has been described in families, unrelated to any underlying causes.
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