PILL BIFURCATI IN A WOMAN WITH ULCERATIVE-COLITIS

A woman with a five-year history of ulcerative colitis that was being treated with sulfasalazine and a restricted diet by a gastroenterologi st, was referred to us because of diffuse alopecia. The most important feature of the trichological examination was that some hair shafts we re bifurcated at multiple, irregular intervals. iron deficiency was th e only biochemical blood abnormality and consequently iron treatment w as begun. Six months later she showed clinical and trichological impro vement. This is an example of ''high-quality protein deficiency'' in w hich, after diffuse telogen shedding, the follicular papilla produces a new hair shaft. Later, during the anagen phase the kinetic papilla m ay change from one tip to two tips producing a bifurcated hair shaft, finally becoming a single-tip again with fusion of the separate branch es. As the protein deficiency was chronic, new splitting with two papi llae might occur repeatedly.