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Year : 2022  |  Volume : 23  |  Issue : 2  |  Page : 181-182

Plica polonica in an 11-year-old female – A rare entity

Punjab Health Systems Corporation, Punjab, India

Date of Submission23-Nov-2021
Date of Decision15-Dec-2021
Date of Acceptance11-Jan-2022
Date of Web Publication30-Mar-2022

Correspondence Address:
Dr. Neerja Puri
H No. 84, Officers Colony, Ferozepur, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijpd.ijpd_161_21

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How to cite this article:
Puri N. Plica polonica in an 11-year-old female – A rare entity. Indian J Paediatr Dermatol 2022;23:181-2

How to cite this URL:
Puri N. Plica polonica in an 11-year-old female – A rare entity. Indian J Paediatr Dermatol [serial online] 2022 [cited 2022 Jun 29];23:181-2. Available from: https://www.ijpd.in/text.asp?2022/23/2/181/341464


Plica polonica is also known as plica neuropathica.[1] In India, plica polonica dates back to Vedas with Shiva, the Hindu God having twisted locks of hair also known as "Jataa". It is the result from noncombing of hair for many years, which results in formation of twisted masses or ropes of hair.[2] It originated in Poland during the 19th century as there was no proper care of hair during that time.[3]

The etiology of plica polonica is unknown, and various factors such as friction and use of harsh shampoos cause weathering of shaft of hair.[4] Poor hair care and psychiatric disorders are contributory factors. Here, the scalp hair forms a mass with entangled plaits and twists.[5]

We report a case of a 11-year-old female child with entangled hair since 2 years [Figure 1] and [Figure 2]. The father of the girl reported that she washed her hair every 10 days but without any soap or shampoo. On examination of the scalp, no erythema, scaling, or secondary bacterial infection. There was no enlargement of the regional lymph nodes. It was not possible to manually separate the hair shafts. Regarding the routine investigations, hemogram showed that her hemoglobin was 10 gm%. A specialist opinion was sought with regard to physical growth and nutritional status which was found appropriate for age. Formal psychological assessment did not reveal any abnormality.
Figure 1: Figure showing entangled mass of hair

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Figure 2: Figure showing side view with entangled plaits

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Her nutritional status of the patient was poor. Her mother had expired 3 years ago during childbirth. Neglect – on account of lack of optimal hygiene by the child herself with poor parental supervision – is the most probable cause for the eventuality in this case.

Plica polonica is also known as bird's nest due to its resemblance to irregular twists of a nest. The management involves shaving the hair and regular cleaning of hair with shampoos. However, seeing this condition at young age is rare.

Declaration of consent

The authors certify that they have obtained all appropriate consent forms, duly signed by the parent(s) of the patient. In the form the parent(s) has/have given his/her/their consent for the images and other clinical information of their child to be reported in the journal. The parents understand that the names and initials of their child will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Kanwar AJ, De D. Plica neuropathica in a 2-year-old boy. Int J Dermatol 2007;46:410-1.  Back to cited text no. 1
Kumar SP, Antony B, Chakravarthy A, Kunhikoyami AM. Plica neuropathica (polonica) in schizophrenia – A case report and review of literature. Indian J Psychiatry 2001;43:281-3.  Back to cited text no. 2
[PUBMED]  [Full text]  
Verma S, Thakur BK. Plica europathica in an 11- month-old boy. Pediatr Dermatol 2014;31:116-7.  Back to cited text no. 3
Palwade PK, Malik AA. Plica neuropathica. Different etiologies in two cases. Indian J Dermatol Venereol Leprol 2008;74:655-6.  Back to cited text no. 4
[PUBMED]  [Full text]  
Mani MZ, Sahni PS. Matting of hair due to halo egg shampoo. Indian J Dermatol Venereol Leprol 1983;49:138-40.  Back to cited text no. 5
[PUBMED]  [Full text]  


  [Figure 1], [Figure 2]


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