What are the other Names for this Condition? (Also known as/Synonyms)

• Ringed Hair Disease

What is Pili Annulati? (Definition/Background Information)

• Pili Annulati is described as an uncommon genetic disorder that manifests as hair abnormalities. The characteristic feature of this condition is the presence of light and dark banded hair, due to which it is also known as Ringed Hair Disease
• The condition is usually noted in early childhood. A large portion of the scalp hair may be affected in Pili Annulati. There are no well-defined treatments available for the condition, although in most cases no significant symptoms or complications are noted. The prognosis is typically good for most individuals

Who gets Pili Annulati? (Age and Sex Distribution)

• Pili Annulati is a rare inherited disorder, and the prevalence of the condition is presently unknown
• Typically, the symptoms are apparent at about 2 years of age. The onset of symptoms may occur in infancy, childhood, or even later
• Both males and females may be affected
• Individuals of all races and ethnicities may be affected

What are the Risk Factors for Pili Annulati? (Predisposing Factors)

• A positive family history may be an important risk factor, since Pili Annulati can be inherited
• Currently, no other risk factors have been clearly identified for the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pili Annulati? (Etiology)

Currently, the exact cause of formation of Pili Annulati is not well-understood.

• The genetic condition is inherited in an autosomal dominant manner, in some cases
• Some cases are known to occur sporadically, meaning a family history of the condition is not observed

Autosomal dominant: Autosomal dominant conditions are traits or disorders that are present when only one copy of the mutation is inherited on a non-sex chromosome. In these types of conditions, the individual has one normal copy and one mutant copy of the gene. The abnormal gene dominates, masking the effects of the correctly function gene. If an individual has an autosomal dominant condition, the chance of passing the abnormal gene on to their offspring is 50%. Children, who do not inherit the abnormal gene, will not develop the condition, or pass it on to their offspring.

What are the Signs and Symptoms of Pili Annulati?

The signs and symptoms of Pili Annulati may vary from individual to another include:

• Hair abnormalities that involve between 20% to 80% of the scalp hair
• Alternating light and dark banded hair strands - this may be less pronounced in individuals with dark hair
• Fine hair
• Brittle hair
• Both facial and body hair involvement may be noted

How is Pili Annulati Diagnosed?

Pili Annulati is diagnosed on the basis of the following information:

• Physical examination of the individual and medical history evaluation; a visual examination of the hair may help the healthcare provider suspect the condition
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Trichoscopy (microscopic hair evaluation): Pili Annulati hairs have alternating sections of light and dark portions of the hair shaft at low magnification
• Polariscopic and/or electron microscopic examination of affected hairs to check for characteristic banding pattern, for confirmation of the condition
• Skin biopsy, if necessary: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pili Annulati?

The complications of Pili Annulati may include:

• Emotional stress
• Hair loss
• Cosmetic issues

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Pili Annulati Treated?

There is no cure for Pili Annulati since it is a genetic condition. The treatment is usually given to manage the signs and symptoms and any complication that develops.

• Topical applications and oral medications may be helpful
• Wigs may be used for severe hair loss

Regular medical screening at periodic intervals with tests and physical examinations are recommended.

How can Pili Annulati be Prevented?

Currently, Pili Annulati may not be preventable since it is a genetic disorder.

• Genetic testing of the expecting parents (and related family members) and prenatal diagnosis (molecular testing of the fetus during pregnancy) may help in understanding the risks better during pregnancy
• If there is a family history of the condition, then genetic counseling will help assess risks, before planning for a child
• Active research is currently being performed to explore the possibilities for treatment and prevention of inherited and acquired genetic disorders

What is the Prognosis of Pili Annulati? (Outcomes/Resolutions)

• The prognosis of Pili Annulati is generally good for most individuals, even though it is an incurable condition
• No severe symptoms or complications are normally reported

Additional and Relevant Useful Information for Pili Annulati:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/