TRICHOTILLOMANIA: A TRICHOTILLOSIS, A TRICHOTILLOTIC, OR A TIC TRICHOTILLOSIS

A 35-year-old Pakistani man working in Saudi Arabia was referred to the Dermatology Clinic, King Fahd Hospital, AlBaha for the evaluation of patches of hair loss from the beard and moustache (Fig. 1). The patches were of 4 years' duration and asymptomatic. The patient was married and had one child. His family was living in Pakistan, but there were no relevant problems, marital or otherwise, and he was happy at work. He spent his vacations back at home with his family. Past history of hair loss was negative. He appeared stable, relaxed, and reasonably dressed and did not manifest psychotic or psychoneurotic features. On the chin there was a well-demarcated patch of alopecia on which broken-off hair and hair of varying lengths were present. There was no scarring or inflammatory signs. Similar patches were seen on the peripheral parts of the moustache. The nails and rest of the skin were normal. A diagno-sis of trichotillomania was made and discussed with the patient. He acknowledged the self-induced nature of his hair loss and admitted to be habitually indulging in it.