Acquired trichorrhexis nodosa: how to diagnose it?

Acquired trichorrhexis nodosa is an uncommon hair disorder, defined as a cuticle response to extrinsic or environmental insults, such as certain chemical agents. In the following report, we present a clinical case of acquired trichorrhexis nodosa and make a critical comparison by trichoscopy, optical microscopy, and scanning electron microscopy. Some diagnostic tools can provide high quality information, but their high cost and low access make them an inconvenient option. When comparing the cost-benefit ratio of each one, we conclude that acquired trichorrhexis nodosa can be easily diagnosed with a careful clinical history and examination using a dermatoscope with non-polarized light.