TRICHOTILLOMANIA
Trichotillomania (TTM) is an obsessive-compulstive disorder in which patients repeatedly pull or manipulate their hair resulting in hair loss.
- Young girls are most commonly affected.
- Parent child issues or psychological problems may be associated.
Psychiatric Comorbidities
TTM patients under 18 years exhibited significantly greater risks of subsequent diagnoses for ADHD (OR: 2.0), conduct disorders (OR: 3.7), tic disorders (OR: 2.2), obsessive-compulsive disorder (OR: 11.0), anxiety disorders (OR: 3.6), dissociative, stress-related, and somatoform disorders (OR: 6.2), mood disorders (OR: 2.5), and suicide attempts (OR: 1.8) compared to controls.
Clinical
Patchy loss of hair with the hairs of non-uniform lengths is seen. The scalp is normal. The main differential diagnosis is alopecia areata (look for exclamation point hairs). Often, a peripheral collar of normal hair is seen along the hair line--the so called Friar Tuck sign.
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