LSS is a key enzyme in the cholesterol biosynthesis pathway, catalyzing the first step in the biosynthesis of cholesterol, steroid hormones, and vitamin D.4The molecular mechanisms of LSS mutations related to hair loss are not exactly clear, as mutations in the LSS gene have been associated with variable phenotypes including HS, severe neuroectodermal syndrome with HS, and congenital cataracts.5 This evidence concerns the gene LSS and histiocytic sarcoma.