Hair tourniquet syndrome: Successful management with a painl
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The clinical entity known as hair tourniquet syndrome was described long ago and occurs when a piece of hair or thread is tightly wrapped around an appendage.This clinical scenario typically arises in the pediatric patient population.The majority of cases exhibit a good response after releasing the tourniquet. Delays in presentation, diagnosis or management can lead to serious complications

Case1

A six-month-old boy presented with a history of excessive crying for the past two days. There was no previous history of medical problems.On examination, the boy appeared well and was vitally stable with no signs of toxicity or lethargy. Examination of the right foot revealed that the middle phalanx of the middle toe had a groove with mild swelling and edema.There were no signs of erythema or abnormal discoloration that suggested ischemic changes. Although no hair was observed during direct visualization of swelled toe, the cause of the pathology is suspected to be secondary to hair tourniquet syndrome.Therefore, a small amount of a depilatory agent (Nair) was applied over the region in which the hair tourniquet syndrome was suspected to be. The boy was then re-evaluated after ten minutes; on this evaluation, the normal appearance of the toe was restored. Moreover, a tiny brown hair was observed in the side of the groove.After washing the toe, the infant was discharged in an improved and stable condition.

Case 2

A healthy 15-day-old baby boy was brought to the emer-gency department with a history of excessive crying,redness and swelling of the left ring finger. The parents denied any history of trauma to the affected site. His Feeding and level of activity were optimal. He was afebrile with normal vital signs but appeared to be in pain and cries continuously. A local examination of the hand revealed a red, swollen and tender left ring finger with a circumferential groove in the area of the middle phalanx of the finger. The capillary refill of the affected finger was normal at less than 3 seconds. The diagnosis of hair tourniquet was suspected, and on closer examination, a hair was observed at the base of the groove. Hair removal cream (the active ingredients of which were calcium hydroxide and sodium hydroxide)is applied to the base of the groove for 10 min. Immediately after this treat-ment, the hair was removed, the swelling decreased dramatically, and the finger became less tender. The patient went home, and the parents were instructed to apply triple-antibiotic ointment to the affected site.l

Conclusively, Hair tourniquet syndrome should be considered in the differential diagnosis of swollen appendages. Depilatory Agents should be utilized to release non-deep tourniquets because this procedure is painless and effective. Allergic Reactions to depilatory creams and non-intact skin are relative contraindications for the use of this technique.
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