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Child abuse and trichotillomania

2005; BMJ; Volume: 330; Issue: 7482 Linguagem: Inglês

10.1136/bmj.330.7482.83

0959-8138

Abir Saraswat,

Medicine and Dermatology Studies History

A 12 year old boy presented with two patches of hair loss on his scalp (figure). A clinical and histopathological diagnosis of trichotillomania was made. On follow up after taking a detailed history, the boy revealed that the hair was being pulled by an abusive teacher during tuition after school. I found two more children similarly abused by the teacher. I discuss the importance of this under-recognised pattern of child abuse and its similarity to trichotillomania. ![][1] Child abuse has varied manifestations. Physical abuse of a child often results in identifiable dermatological signs, which can pinpoint the diagnosis. Abuse can closely resemble other dermatoses, however, resulting in diagnostic errors. Trichotillomania is a condition currently classified as an impulse control disorder, which is characterised by repetitive pulling of one's own hair resulting in alopecia. ### Case report A 12 year old boy was referred by his family physician to the dermatology outpatient department with a complaint of partial hair loss on his scalp that was noticed one week before. On examination, there were two patches of partial alopecia on the temporovertical scalp measuring 2 cm by 2 cm and 3 cm by 3 cm. The … [1]: /embed/graphic-1.gif