PMC10251288_01
(a) Silver-gray hair over scalp. (b) mottled pigmentation and gray hair over the trunk
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PMC10251288_01_IJT-15-36-g001.jpg
F1
Dermatological examination showed silvery-gray or metallic hair over scalp and body, perioral hypopigmentation, and diffuse hyperpigmentation with guttate hypopigmented macules over trunk and extremities [Figure 1].
(a) Light microscopy at x40, showing regularly arranged pigment clumps throughout the hair shaft. Peripheral smear (Leishman stain, x100) showing (b) Azurophilic inclusion bodies in neutrophil (black arrow), (c) inclusion body in lymphocyte (black arrow)
IJT-15-36-g002.jpg
PMC10251288_01_IJT-15-36-g002.jpg
F2
PLT - 5000/mul, TGL - 386 mg/dl, and serum ferritin - 1800 ng/ml. Peripheral smear showed cytoplasmic inclusion bodies in neutrophils, large granular lymphocytes [Figure 2], microcytic hypochromic anemia, and severe thrombocytopenia. Hair microscopy showed evenly distributed melanin granules of regular diameter over the entire shaft [Figure 2].
PMC10251288_02
(a) Silver-gray hair over scalp, eyebrows, and eyelashes. (b) Light microscopy at x 40, showing large pigment clumps in the medulla of the hair shaft
IJT-15-36-g003.jpg
PMC10251288_02_IJT-15-36-g003.jpg
F3
Dermatological examination revealed hypopigmentation of skin, silver gray hair over the scalp, eyebrows, and eyelashes, and a normal iris pigmentation [Figure 3]. Scalp hair microscopy revealed multiple irregular large clumps of melanin in the medulla of the hair shaft [Figure 3].