Trichotemnomania: Hair Loss Mediated by a Compulsive Habit Not Admitted by Patients

Orgaz‐Molina, Jacinto; Husein-Elahmed, Husein; Soriano-Hernández, María Isabel; Arias‐Santiago, Salvador

doi:10.2340/00015555-1232

Cited by 16 publications

(24 citation statements)

References 9 publications

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“…Trichotemnomania is an obsessive‐compulsive habit of cutting hair with scissor or razor. On literature review, we found only a handful of cases of trichotemnomania . The reported patients were mostly adult females and were frequently associated with other psychiatric disease.…”

Section: Trichotemnomania In a Familymentioning

confidence: 97%

Trichotemnomania in a family

et al. 2019

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A 10-year-old school-going boy was brought to the dermatology department by his anxious parents for complaints of loss of hair over scalp, eyebrows, and eyelashes during the previous week.The onset of hair loss was sudden and not associated with any other local or systemic symptoms. The shed hair was found in clusters on the floor of the house and on the child's clothing. On further enquiry, the child's grandmother, aged 55 years, was also found to have lost her braid overnight. The child and his parents denied any self-manipulation.On examination, there was multifocal hair loss in a linear bizarre pattern over the vertex, eyebrows, and eyelashes ( Fig. 1). Trichoscopic evaluation carried out using a hand-held Dermlite II hybrid M dermatoscope at 109 magnification in polarized mode showed clean sharply cut ends, which were of equal length of around 5-6 mm from the scalp surface. Similar findings were noted over the eyebrows and eyelashes (Fig. 2).In addition, superficial abrasion suggestive of micro trauma was noted over the eyelid (Fig. 2). Hair pull test was negative, and nails were normal. By clinical and trichoscopic correlation, a diagnosis of trichotemnomania was established.On further probing by a psychiatrist, the child was found to be pressured at school by peers and teachers on his scholastic performance. Being the only child at home, he was frequently compared by his mother with brilliant students in the neighborhood. For the last few months, he would find excuses to miss school and use to spend more time with his grandmother, with whom the index patient shared a common bedroom. During this time, the grandmother's braid was 'found to be cut' overnight. This event drew a lot of attention and was widely propagated in both conventional and social media as a "demonic act of Satan." In a couple of weeks, a lot of similar cases were reported from various parts of northwestern India. 1 Media reports attributed this to some unexplained evil spirit, and the same reason was given by the grandmother. Common people and masses at large attributed it to some supernatural event due to cultural beliefs in the concept of ghosts, spirits, and supernatural prevalent from ages in this part of the world. However, later it was found to be a voluntary act. Thus symptom production in the form of braid cutting in the grandmother was a deliberate production of symptoms for unconscious gain, anxiety reduction, and a cry for help.Encouraged by the "sympathetic attention" drawn by the grandmother, the same was modeled by the index patient, wherein the child started cutting his own hairs. The child's parents stopped sending him to school thereafter. The symptom production provided an unconscious gain to the child in the form of escape from his stressful situation at home and school. These symptoms were unconsciously modeled as they had acceptance in the community.

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Section: Trichotemnomania In a Familymentioning

confidence: 97%

Trichotemnomania in a family

et al. 2019

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“…The hair is usually cut with scissors or by shaving and the diagnostic key is the presence of follicle openings with filled hair shafts within a healthy-looking scalp [6].…”

Section: Discussionmentioning

confidence: 99%

Trichoteiromania: An Atypical Case Associated with the Claude Bernard Horner Syndrome

Diniz

Abuawad

Silva

et al. 2017

Skin Appendage Disord

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“…While trichotillomania has been well known for a century and has been described in the Diagnostic and Statistical Manual of Mental Disorders (DSM) since 1987, TT is a very rare and underestimated disorder [3]. Despite the fact that both trichotillomania and TT are presented with self-induced alopecia, TT patients cut their hair with scissors or a razor instead of pulling it and have an obsessive-compulsive habit, which they are not willing to change [4]. Resistance to admitting the illness is generally common in both trichotillomania and TT.…”

Section: Introductionmentioning

confidence: 99%

“…Resistance to admitting the illness is generally common in both trichotillomania and TT. Patients usually feel guilty and embarrassed because of their habit [4]. Although trichotillomania is often well diagnosed and recalled by dermatologists, incidents of TT are often misdiagnosed.…”

Section: Introductionmentioning

confidence: 99%

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Three adolescent cases of a very rare disorder: Trichotemnomania

Mutluer

Ateş²,

Nasıroğlu

et al. 2018

Psychiatry and Clinical Psychopharmacology

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Trichotemnomania (TT) is characterized as the cutting or shaving of hair, which is an obsessivecompulsive habit. TT takes its name from a fusion of Greek words: thrix (hair), temnein (to cut), and mania (madness). TT is a very rare disease with only five case studies reported in the literature and to the best of our knowledge; no data are available on adolescents. This study focuses on three cases of adolescents with TT. All patients have been evaluated by a dermatologist and two child and adolescent psychiatrists. Dermatological examinations included medical history, physical examination, dermoscopy assessment, and laboratory investigations. Detailed psychiatric assessments consisted of socio-demographic data, clinical history, semi-structured interviews, and psychometric tests. Three cases with TT were both diagnosed with obsessive-compulsive disorder. Two of them diagnosed comorbid social anxiety disorder (in cases 1 and 2), and one case diagnosed with comorbid general anxiety disorder (in case 3) and agoraphobia (in case 3). Cases 1 and 2 were prescribed 50 mg/day of sertraline; however, case 3 refused the treatment. In conclusion, TT may be confused with trichotillomania or other disorders presented with alopecia. Differential diagnoses may be due to histopathological changes or dermoscopic assessment. Dermatologists should consider TT when a supposed alopecia areata looks somewhat unusual and should refer these patients for psychiatric evaluation.

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Trichotemnomania: Hair Loss Mediated by a Compulsive Habit Not Admitted by Patients

Cited by 16 publications

References 9 publications

Trichotemnomania in a family

Trichotemnomania in a family

Trichoteiromania: An Atypical Case Associated with the Claude Bernard Horner Syndrome

Three adolescent cases of a very rare disorder: Trichotemnomania

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