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Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Anna Waśkiel-Burnat, Lidia Rudnicka, Małgorzata Olszewska, Adriana Rakowska, Ralph M. Trüeb, Isabel Kolm
Trichotillomania is an impulsive control disorder characterized by a compulsive urge to pull out one's own hair, leading to noticeable hair loss. The most important differential diagnosis is alopecia areata. However, trichotillomania often co-exists with alopecia areata,64 which may pose a special diagnostic challenge.
Integrative psychodynamic therapy
Published in Stacy K. Nakell, Treatment for Body-Focused Repetitive Behaviors, 2023
Those who did come before me saw very positive treatment outcomes in small studies. Caroline Koblenzer relied on case studies to reflect on the important benefits of psychodynamic treatment in her chapter in the book Trichotillomania (1999), making a strong argument: I have previously reported a positive outcome in four patients out of a series of six similar patients who accepted referral for psychodynamic psychotherapy … These therapies have repeatedly been demonstrated to be effective in the treatment of trichotillomania.(p. 142)
Psychocutaneous Disorders
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Kristen Russomanno, Vesna M. Petronic-Rosic
Laboratory studies: Physical examination and obtaining a thorough history are key in the evaluation and diagnosis of trichotillomania. Trichoscopy (i.e., dermatoscopic examination of the hair and scalp) may be helpful for supporting the diagnosis. Under magnification, hairs of various lengths can be appreciated in addition to other diagnostic clues, including flame hairs (i.e., remnants of anagen hairs), coiled hairs, and the v-sign (i.e., two small hairs emerging from one follicle). If there is diagnostic uncertainty, then a scalp biopsy may be performed to support the diagnosis.
A comparison of phenomenological, clinical and familial psychiatric features of pediatric OCD and trichotillomania
Published in International Journal of Psychiatry in Clinical Practice, 2022
Dilşad Yıldız Miniksar, Tuğba Yüksel, Büşra Öz, Mikail Özdemir
The most remarkable limitation of this study is that the severity of trichotillomania has not been assessed. Another limitation of this study is the sample size and the lack of instruments for assessing continous variables (e.g., anxiety and depressive symptoms) and their difference across groups. Contrary to popular belief, trichotillomania is a common, neglected disorder that may lead to intense loss of functionality in all fields of life. Similarities between OCD and TTM have been widely recognised. Nevertheless, there is evidence of important differences between these two disorders. This suggests that TTM is a heterogeneous disorder. Hence, elucidating the aetiology of TTM is remarkably crucial for planning treatment and generating a treatment algorithm, and previously performed studies are inadequate, specifically in the paediatric age group. Single-centered studies with larger populations cannot be conducted due to the nature of the disease and the reluctance of patients to apply; thus, multi-centered, coordinated, and large-scaled studies should be performed.
Pharmacotherapy for trichotillomania in adults
Published in Expert Opinion on Pharmacotherapy, 2020
Christine Baczynski, Verinder Sharma
Individuals presenting with a history of hair pulling should be evaluated using the DSM-5 criteria for confirmation of diagnosis as well as determination of current and lifetime comorbid psychiatric disorders. Trichotillomania should be differentiated from conditions in which hair pulling can be a symptom of things such as neurodevelopmental disorders, other obsessive-compulsive and related disorders, dermatological conditions, psychotic disorders, and substance-related disorders [5]. The Structured Clinical Interview for DSM-5 is considered the gold standard for diagnosing psychiatric disorders, however, it may not be feasible to do so due to time constraints [82]. Thorough medical assessment is indicated when the patient is reporting ingesting hair or when such behavior is suspected. Assessment of suicide risk should be routinely carried out in patients with comorbid depression.
Probable emergence of symptoms of trichotillomania by atomoxetine: a case report
Published in Psychiatry and Clinical Psychopharmacology, 2019
Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood with adverse impacts on school/work life involving symptoms of inattention and hyperactivity-impulsivity. Atomoxetine, the first nonpsychostimulant agent approved by the Food and Drug Administration (FDA) for the treatment of ADHD [1], increases norepinephrine levels in the synaptic space by inhibiting presynaptic reuptake and through an indirect effect on dopamine levels [2]. Trichotillomania (TTM), also known as hair-pulling disorder, is an obsessive-compulsive and related disorder characterized by a long-term urge that results in the pulling out of one’s hair from any part of his/her body [3]. The most common site affected by TTM is the scalp. The other common regions are eyebrows, eyelashes, pubic area, face, and less frequently other body hair [4]. Usually, the disorder is chronic and leads to distress. Studies strongly support the role of serotonin and dopamine dysfunction in the pathophysiology of TTM [5]. A possible association between TTM and psychiatric medications, such as aripiprazole [6] and fluoxetine [7], has been reported. There are case reports of TTM associated with dopaminergic agents like stimulants [8–11]. There is a case report regarding children with ADHD presenting with atomoxetine-associated TTM by pulling hairs from the eyebrows [12]. We aimed to present a child male patient who was diagnosed with TTM by pulling hairs from the scalp during his treatment with atomoxetine.