Plica neuropathica – unraveling the mystery of Plica polonica

Abstract

Background: Plica as a disease entity appeared fi rst in the 13th century. Its aetiology is still unknown and not fully understood. Being, in fact, an irreversible condition of tangling and felting the hair, its origin was interpreted in various ways, from religious ones, through lack of hygiene to mental illness. Although p. polonica originates from Eastern and Central Europe, and p. neuropathica, typical of Indian people, was fi rst described in England, many characteristics connect these two conditions. Aim and Objectives: The study aimed to review the plica species over the centuries and to compare p. neuropathica and p. polonica. Materials and Methods: PubMed and Google Scholar databases were searched for medical articles, books and case studies on plica published up 1884 to 2020. We conducted a systematic and critical review of the literature to compare p. polonica and p. neuropathica. Results: Plica polonica and Plica neuropathica are the same disease entity. Conclusion: The variety of names and interpretations of the disease has made plica a condition still to be fully explained.

Plica Neuropathica as a Presenting Rare Dermatologic Symptom of Schizophrenia

“…5 The disorganized behavior and inappropriate self-care observed in patients with psychiatric disorders may increase risk of PN development. 6,7 PN is overrepresented among patients with mental disorders. 17 However, few cases of psychological disturbances have been described in the literature.…”

“…3,6 PN is considered a relatively rare condition with an unknown incidence; however, a female predilection has been documented, likely since women tend to have longer hair and increased risk of developing psychological disorders. [7][8][9] PN was initially reported by Le Page in 1884, who described a 17-year-old female patient suffering from hysteria, whose hair was tangled into a solid mass that she could not untangle. 10 Subsequently, additional PN cases have been associated with ionic or herbal shampoos, vigorous hair care practice, self-neglect, systemic infection, parasitic infestation, immunosuppressive agents, or psychiatric morbidities.…”

“… 3 , 6 PN is considered a relatively rare condition with an unknown incidence; however, a female predilection has been documented, likely since women tend to have longer hair and increased risk of developing psychological disorders. 7–9 …”

“…It was prevalent in Central and Eastern Europe, and among members of the Sadhus tribe in India. 7 In the first reported case by Le Page, the patient’s parents believed that PN was a visitation from God. 10 In Thailand, enquiries and discussions regarding PN tend to include superstitious aspects.…”

“…Previously reported psychological conditions relevant to PN include hysteria, autism, schizophrenia, severe reactive depression, obsessive-compulsive disorder, and mixed anxiety-depressive disorder. 7 , 10 , 18–21 Reported cases of PN associated with schizophrenia are summarized in Table 1 . 21–25 …”