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Cheng S et al. – The authors data suggest that clinically apparent fragile hair in childhood is only rarely associated with a diagnosis of TTD. The tiger–tail change is sensitive but not wholly specific to TTD. The authors propose that the term trichothiodystrophy be limited in its use to define sulphur–deficient hair rather than as a diagnostic term in a heterogeneous and incoherent multisystem disorder, where sulphur–deficient hair is one feature.

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