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Trichotillomania +/- trichobezoar: revisited
1Dermato-Venereology (Skin/VD) Centre, Sehgal Nursing Home, Panchwati, Azadpur, Delhi and Skin Institute and School of Dermatology, Greater Kailash, New Delhi, India. drsehgal@ndf.vsnl.net.in
Summary
Trichotillomania is a hair-pulling disorder causing hair loss and potential gastrointestinal complications like trichobezoar. Diagnosis involves history, clinical signs, and hair examination, with varied treatments based on age.
Area of Science:
- Psychosomatic Medicine
- Gastroenterology
- Dermatology
Background:
- Trichotillomania involves an irresistible urge to pull hair, leading to alopecia.
- Ingestion of pulled hair can cause trichobezoars, a serious complication.
Purpose of the Study:
- To describe the psychosomatic entity of trichotillomania.
- To outline its clinical presentation, complications, and diagnostic criteria.
- To discuss treatment approaches for different age groups.
Main Methods:
- Clinical case review and literature synthesis.
- Analysis of diagnostic features, including hair-root examination.
- Review of treatment modalities for trichotillomania and trichobezoar.
Main Results:
- Trichotillomania presents as non-scarring alopecia.
- Trichobezoars, including Rapunzel syndrome, are significant complications.
- Hair-root examination showing a lack of telogen hairs aids diagnosis.
Conclusions:
- Trichotillomania requires a thorough diagnostic approach.
- Prognosis differs significantly between childhood (habit disorder) and adult (deeper psychopathology) cases.
- Treatment involves psychotherapy, medications like SSRIs, and surgery for trichobezoars.