Sir,
A 10-year-old boy presented with mildly irritating black material in the right sole. It was gradually migrating few centimeters over a period of 10 days. On examination, a thin, black material resembling hair shaft was seen embedded below the skin [Figure 1]. The black material was more visible after local anesthesia was injected [Figure 2]. Initially, a 23G needle was used near the center to remove the material, but it broke into two pieces. Hence, a slit was made parallel to the black material with a 23G needle, and it was extracted using small forceps. It was found to be a hair shaft [Figure 3]. Dermoscopy was not done. There was very minimal bleeding immediately after removal [Figure 4].
Figure 1.
Black material before anesthesia
Figure 2.
Black material more visible after local anesthesia
Figure 3.
Hair shaft after removal
Figure 4.
Immediately after removal
Cutaneous pili migrans is a rare skin condition, in which the hair shaft fragment is embedded and migrates in the superficial skin. It was first reported in 1957 by Yaffee.[1] Since 1957, 27 cases of cutaneous pili migrans have been described using various terms such as burrowing hair, creeping hair, migrating hair, and embedded hair.[2] Only two cases are reported from India.[3] Various locations such as the ankle, sole, toe, breast, cheek, neck, jaw, abdomen, and leg have been reported. Hair penetrates the skin owing to sharp hair tip or due to the broken epidermis at the point of entry of hair shaft.[4] The removal of the hair shaft heals the lesion completely. It is more common among barbers. Asian hair has high tensile strength and the largest cross-sectional area compared to that of all other ethnic groups.[5] This may be the reason for more cases reported from East Asian countries. Sometimes, hair embedded in the skin is found immobile. This may be called cutaneous embedded hair. If the hair migrates, the term cutaneous migrans is more suitable.
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The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
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REFERENCES
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