Barber's disease

Barber's disease is an acquired occupational disease produced by short customers' hairs that penetrate the interdigital spaces of the hands forming a pilonidal sinus

• been reported to occur mostly on the hands of male hairdressers
  
  
• interdigital spaces are susceptible to penetration by hair because the epidermis is very thin in this area, it is easily irritated by moisturizing agents and shampoos routinely used by hairdressers
  • the tile-like formation of the cuticula can act as a barbed hook
    
    
• most sinuses are asymptomatic
  • however can be complicated by abscess formation, cellulitis, lymphangitis and osteomyelitis
    
    
• thorough removal of any hairs that have penetrated the epidermis during the working day could prevent the formation of the disease
  
  
• surgical excision, curettage and primary healing seem to be a safe method of treatment.

Notes:

• pilonidal sinus is an acquired condition caused by penetration of hair fragments into the skin
  • a chronic inflammatory response results in the formation of a sinus and later a cyst
  • more hairs then become entrapped within the established sinus
  • usually develops in the sacrococcygeal area or other hair-bearing areas
• the disease is mostly observed in hairdressers, but it has also been reported sporadically in other professions, as male sheep shearer, dog groomer or milker of cows

Reference:

• Banerjee D. The aetiology and management of pilonidal sinus. J Wound Care. 1999;8:309-10.
• Papa CA, Ramsey ML, Tyler WB. Interdigital pilonidal sinus in a dog groomer. J Am Acad Dermatol. 2002;47:S281-2.
• Patel MR, Bassini L, Nashad R, Anselmo MT. Barber's interdigital pilonidal sinus of the hand: a foreign body hair granuloma. J Hand Surg [Am] 1990;15:652-655.
• Schroder CM, Merk HF, Frank J. Barber's hair sinus in a female hairdresser: uncommon manifestation of an occupational dermatosis. JEADV. 2006;20:209-11