Trichotillomania
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Trichotillomania

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Trichotillomania Trichotillomania Presentation Transcript

  • Trichotillomania Nargess Tavakoli Guilan University of Medical Sciences
    • Alopecia resulting from repetitive hair manipulations by the patient’s own hand
  • physiopathology
    • A primary psychiatric disorder
    • One of traumatic alopecia
    • Age: Any / childhood
    • Sex: F>M
    • Depression ,anxiety
    • Head
    • Scalp frontotemporal
    • eyebrow
    • eyelash
  •  
    • Poor insight
    • sedentary activities
    • stroking, twisting, rubbing  pulling  Playing with the hair
    • Geometrical / Incomplete / Nonscarring ( typical)
    • Eyebrow / eyelash
    • A somewhat deficient volume of hair
  • A geometric patch of incomplete alopecia
  • Note the preservation of the hairline
  • bizarre-patterned lesion covered with short hairs (not bald).
  • Alopecia patch
    • Single / multiple
    • Small / large
    • Except margin?
    • Whole scalp? Rare
  • magnifying glass
    • (1) Newly growing short hairs
    • (2) Broken short hairs
    • (3) Vellus or indeterminate hairs
    • (4) Black dots
    • (5) Empty follicular orifices
  • black dots
    • Sometimes, although the hair thinning is apparent, the lesion is not well defined
    • Pull test  Neg.
    • Trichogram  In areas of re growing hairs 100% anagen
  • Diagnosis
    • A high index of suspicion for the diagnosis is essential
    • Biopsy?
  • Treatment
    • Consult a psychiatrist
    • Clomipramine
    • Fluxetin
    • Pimozide
  • Prognosis
    • Very young children  excellent.
    • Late childhood & adolescence  usually good
    • Adults  poor
  •