Trichotillomania associated with alopecia areata

An 18-year-old woman had alopecia areata of two years' duration. Initially, the clinical findings were quite characteristic of alopecia areata; however, the hair that grew back into the areas of alopecia remained short and sparse. Histopathologic examination suggested trichotillomania, which was confirmed by shaving a small area on the scalp and observing normal hair regrowth.