Dermatology: Practical and Conceptual Image Letter | Dermatol Pract Concept. 2022;12(2):e2022059 1 Dermatology Practical & Conceptual Case Presentation In short, anagen hair syndrome (SAS), the hairs are short, fine, and sparse since birth even if the typical patient pres- ents to a medical consultation around the age of 5-6 years. Parents often complain the hair doesn’t grow long and that they have never been cut. The presence of short hair shafts is due to a short duration of the anagen phase. Hair shafts have also been described as thinner and in telogen phase. The clinician should rule out congenital hypotrichosis, loose anagen hair syndrome, telogen effluvium. Teaching Point We propose the card test as a quick and inexpensive method to help in the diagnosis of SAS. Tufts of hairs are placed on a card (Figure 1A) and observed with a dermoscope at 20X magnification: thin hair shafts with pointed tips are proof the hairs have never been cut (Figure 1B). This test can be done even without pulling the hair out of the scalp. Card Test as a Simple Method to Diagnose Short Anagen Syndrome Matilde Iorizzo1, Michela Starace2,3 1 Private Dermatology Practice, Bellinzona/Lugano, Switzerland 2 Dermatology, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy 3 Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy. Citation: Iorizzo M, Starace M. Card Test As a Simple Method to Diagnose Short Anagen Syndrome. Dermatol Pract Concept. 2022;12(2):e2022059. DOI: https://doi.org/10.5826/dpc.1202a59 Accepted: August 19, 2021; Published: April 2022 Copyright: ©2022 Iorizzo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing interests: None. Authorship: Both authors have contributed significantly to this publication. Corresponding author: Matilde Iorizzo, MD PhD, Private Dermatology Practice, Viale Stazione 16, 6500 Bellinzona (Switzerland). E-mail: matildeiorizzo@gmail.com Figure 1. (A) The card test showing how a tuft of short hairs should be placed on a card before observing them with a dermatoscope. (B) Multiple and exclusively pointed tips, showing the short shafts have never been cut, and after cut, are easily seen with a 20X magnification.