Familial trichotillomania in three generations

Area of Science:

• Psychiatry
• Genetics
• Dermatology

Background:

• Trichotillomania (TTM) is an impulse control disorder involving recurrent hair pulling.
• A genetic component for TTM is suggested by limited familial case reports.
• Understanding the etiology of TTM is crucial for effective treatment strategies.

Observation:

• A 13-year-old male presented with focal scalp hair loss.
• Clinical examination revealed patchy alopecia with characteristic short, broken hairs.
• Dermoscopy and histopathology confirmed trichotillomania.

Findings:

• The patient's father reported a history of compulsive beard pulling.
• The paternal grandfather also exhibited severe beard pulling behavior since puberty.
• This represents the first reported instance of TTM observed across three generations within a family.

Implications:

• This case strongly suggests a significant genetic contribution to trichotillomania.
• The findings support a complex inheritance pattern for TTM.
• Thorough family history assessment is vital for diagnosing and managing TTM patients.