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 .