Generalized hair casts due to traction.

Peripilar keratin casts, also called pseudonits or hair casts, are thin, elongated, greyish-white, cylindrical, sleeve-like structures that encircle the hair shaft and can easily be slid along the hair. They may be clinically misdiagnosed as nits. In addition to physical removal, keratolytic lotions or shampoos are helpful. We report an 11-year-old girl with pseudonits. Although it is not a rare condition, underdiagnosis is common.