Trichotillomania is a chronic, mental disease of impulse control, characterized by repetitive, compulsive, and self-induced hair pulling. It can occur at any age but is observed more often in adolescents, with a strong predominance in females. Diagnosis of trichotillomania may be difficult, and its effective treatment challenging. The aim of this study is to critically review current literature regarding diagnostic procedures and treatment of trichotillomania, including psychotherapy, N-acetylcysteine, naltrexone, topiramate, atypical neuroleptics, and selective serotonin-reuptake inhibitors. The importance of cooperation between dermatologists and psychiatrists is emphasized to shorten the time to diagnose the disease and begin appropriate treatment. Finally, trichotillomania is also often connected with trichophagia, which may lead to formation of trichobezoars and cause a direct danger to the patient’s health and even life due to the risk of intestinal obstruction and the need for surgical intervention. Based on thorough literature review, we conclude that diagnosis of trichotillomania can be challenging. Trichoscopy could help to distinguish trichotillomania from other types of hair loss. Most clinical trials using various treatment options have been conducted on small groups of patients, and the potential benefits determined using various scales. Therefore, it is difficult to compare the effectiveness of different treatment methods. There is also a lack of studies assessing treatment efficacy over longer periods of time. Thus, there is a need to perform better-designed studies in the near future to optimize current treatment modalities for trichotillomania.

Recent studies have reported a significant increase in the incidence of type 2 diabetes in the past 30 years. They also predict that this trend will continue. This is related to a change in lifestyle, which results in a parallel increase in the incidence of overweight and obesity. However, symptoms of the metabolic syndrome, so far closely related to abdominal obesity, are relatively common among people with normal body mass index (BMI) and waist circumference. The aim of the study is to present the TOFI phenotype (thin outside, fat inside) as an important factor in pathogenesis of type 2 diabetes. In the 1980s, the first study of the MONW (metabolic obese normal weight), a phenotype that is characterized by metabolic diseases in people with normal body weight. Since then, no uniform criteria have been established for MONW deployment, which has created difficulties in identifying affected individuals. Recent work has appeared describing the TOFI phenotype, which seems to lead to the appearance of MONW. People affected by this problem, in spite of undersized fatty tissue, have an increased amount of adipose tissue surrounding the internal organs, which increases the risk of insulin resistance and type 2 diabetes. In the diagnostics of the TOFI phenotype, magnetic resonance imaging is of paramount importance. Previous studies did not provide clear answers about the pathogenesis of TOFI nor which factors stimulate its development. Prophylaxis and treatment of the syndrome include increased physical activity, the promotion of correct eating habits, and a use of metformin.