title: Trichotillomania: a case report with clinical and dermatoscopic differential diagnosis with alopecia areata.
abstract: Trichotillomania is a psychodermatologic disorder characterized by uncontrollable urge to pull one's own hair. Differential diagnoses include the most common forms of alopecia such as alopecia areata. It is usually associated with depression and obsessive-compulsive disorder. Trichotillomania treatment standardization is a gap in the medical literature. Recent studies demonstrated the efficacy of N-acetylcysteine (a glutamate modulator) for the treatment of the disease. We report the clinical case of a 12-year-old female patient who received the initial diagnosis of alopecia areata, but presented with clinical and dermoscopic features of trichotillomania. She was treated with the combination of psychotropic drugs and N-acetylcysteine with good clinical response. Due to the chronic and recurring nature of trichotillomania, more studies need to be conducted for the establishment of a formal treatment algorithm.
authors.affiliation: Department of Dermatology of the Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.
authors.forename: Ana Cecília Versiani Duarte
authors.initials: AC
authors.lastname: Pinto
authors.affiliation: Department of Dermatology of the Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.
authors.forename: Tatiana Cristina Pedro Cordeiro de
authors.initials: TC
authors.lastname: Andrade
authors.affiliation: Department of Dermatology of the Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.
authors.forename: Fernanda Freitas de
authors.initials: FF
authors.lastname: Brito
authors.affiliation: Department of Dermatology of the Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.
authors.forename: Gardênia Viana da
authors.initials: GV
authors.lastname: Silva
authors.affiliation: Department of Dermatology of the Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.
authors.forename: Maria Lopes Lamenha Lins
authors.initials: ML
authors.lastname: Cavalcante
authors.affiliation: Department of Dermatology of the Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.
authors.forename: Antonio Carlos Ceribelli
authors.initials: AC
authors.lastname: Martelli
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use; D000506:Alopecia Areata / Q000175:diagnosis*; D002648:Child; D003937:Diagnosis, Differential; D004316:Doxepin / Q000627:therapeutic use; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D010868:Pimozide / Q000627:therapeutic use; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D014256:Trichotillomania / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D011619:Psychotropic Drugs; D005473:Fluoxetine; D004316:Doxepin; D010868:Pimozide; D000111:Acetylcysteine