Poliosis circumscripta: overview and underlying causes

J Am Acad Dermatol. 2013 Oct;69(4):625-33. doi: 10.1016/j.jaad.2013.05.022. Epub 2013 Jul 12.

Abstract

Although traditionally known as "white forelock," poliosis circumscripta, defined as a localized patch of white hair in a group of hair follicles, can involve any hairy area on the body including the scalp, eyebrows, and eyelashes. Microscopically, poliosis demonstrates either decreased or absent melanin and/or melanocytes in the hair bulbs of the affected hair follicles. Classically, poliosis is known to occur in the setting of several genetic syndromes including piebaldism, Waardenburg, and tuberous sclerosis. In addition, poliosis has been described in association with various acquired conditions. These include inflammatory conditions, benign and malignant neoplastic entities that are mainly melanocytic, medications, and others. In this review, we aim to describe the different conditions where poliosis may be encountered, with the aim of helping the clinician to better evaluate any patient presenting with poliosis.

Keywords: AA; TSC; VKH; Vogt-Koyanagi-Harada; alopecia areata; poliosis; poliosis circumscripta; tuberous sclerosis; white forelock.

Publication types

  • Review

MeSH terms

  • Adult
  • Algorithms
  • Alopecia Areata / epidemiology
  • Alopecia Areata / pathology
  • Biopsy, Needle
  • Causality
  • Comorbidity
  • Female
  • Hair Diseases / epidemiology
  • Hair Diseases / metabolism
  • Hair Diseases / pathology*
  • Hair Follicle / pathology*
  • Humans
  • Hypopigmentation / epidemiology
  • Hypopigmentation / metabolism
  • Hypopigmentation / pathology*
  • Immunohistochemistry
  • Male
  • Melanins / metabolism
  • Melanocytes / pathology
  • Piebaldism / epidemiology
  • Piebaldism / metabolism
  • Piebaldism / pathology*
  • Pigmentation Disorders / metabolism
  • Pigmentation Disorders / physiopathology
  • Prognosis
  • Risk Assessment
  • Tuberous Sclerosis / epidemiology
  • Tuberous Sclerosis / metabolism
  • Tuberous Sclerosis / pathology
  • Uveomeningoencephalitic Syndrome / epidemiology
  • Uveomeningoencephalitic Syndrome / pathology
  • Waardenburg Syndrome / epidemiology
  • Waardenburg Syndrome / pathology

Substances

  • Melanins