International Journal of Clinical & Medical Images

Trichoteiromania is the term used to refer to the compulsive action of scratching and rubbing off the scalp. Trichotillomania is a tic of manipulation and/or tearing of hair, eyelashes, eyebrows, nose hair, or other body hair repeatedly. This leads to manifest alopecia on the affected part of the body. This is a 14-year-old male presented for consultation of an alopecic eyelash and eyebrow patch of 2 months duration. Family history was negative for alopecia areata or other hair disorders. Examination showed an irregular alopecic patch on the eyelashes and marigolds (Figure 1) with a negative pull sign. Dermoscopy showed broken hair, V-shaped hair; distal snoring with brush sign, forked hair (Figures 2-4). There were no hair shaft abnormalities in the scalp or other hair regions. On further questioning, the patient revealed repetitively touching, plucking and scratching her hair while studying for tests. The patient was subsequently diagnosed with trichotillomania associated with trichotillomania. He was treated with N-acetylcysteine 600 mg associated with cognitive behavioral psychotherapy, and the evolution is on follow-up