ABSTRACT
Introdução: Os cilindros capilares (CC) caracterizam-se por concreções cilíndricas branco-amareladas que envolvem a haste capilar, sem, porém, a ela aderir. Relato de caso: Paciente sexo feminino, 20 anos, fototipo III. Vem a consulta dermatológica devido a queda de cabelos de início há 3 meses. No início do quadro começou a observar nódulações esbranquiçadas aderidas às hastes dos fios, na porção proximal dos mesmos, assintomáticos. Exame micológico direto e cultura negativos. Levantada então a hipótese clínica de eflúvio telógeno e cilindros capilares. Foi então prescrito solução capilar de ácido retinóico 0,05% diariamente e orientada a não amarrar os fios. A paciente retornou ao consultório 4 semanas após, com diminuição das concreções esbranquiçadas. Discussão: Embora os CC sejam uma condição benigna e de baixa morbidade, é difícil o diagnóstico nas primeiras consultas, o que gera custos desnecessários com tratamentos inadequados.
Introduction: The capillary cylinders characterize for white-yellow cylindrical concretions that involve the hair shaft, without, however, adhering to it. They were described for the first time in 1957 for Kligman, and even though they are not uncommon, its bibliographic references are somehow rare, mostly in books. Case report: Female patient, 20 years old, photype III. The patient comes to the dermatologist complaining of losing hair for the last three months after applying a "brush progressive" which contained formaldehyde, without information of its concentration in the product. In the beginning the patient has also noticed some white little balls attached to the hair shafts in the proximal portion of it, whit no symptoms. She still reports having the habit to tie her hair strongly. To the dermatological examination, there have been noticed homogeneous thickness hair, positive to the traction (falling 6 hairs to traction in the right temporal region) and a discreet bitemporal rarefaction. The patient presented white concretions mostly in the front-temporal regions, which easily release to manipulation. Direct mycological examination and culture were negatives. There have been brought up two clinical hypothesis: telogen effluvium and capillary cylinders. It has been prescribed capillary solution of retinoic acid 0,05% daily and oriented to not tie her hair. The patient came back 4 weeks later, with decreasing of white concretions. Discussion: Even though the capillary cylinders are benign conditions and have low morbidity, and the fact of not being well known, frequently, there is confusion in its diagnosis, which can generate unnecessary costs and inadequate treatment.