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Correspondence |

The Band-Aid Sign of Trichotillomania: A Helpful Diagnostic Technique in the Setting of Hair Loss

Heidi B. Prather, BS; Roopal V. Kundu, MD; Matthew J. Mahlberg, MD
Arch Dermatol. 2010;146(9):1052-1053. doi:10.1001/archdermatol.2010.230.
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Historically, self-inflicted hair loss, or trichotillomania, was first recognized and named by François Henri Hallopeau, a French dermatologist who combined 3 Greek words to describe this condition: thrix (hair), tillein (pulling), and mania (madness).1 Patients with trichotillomania, a neuropsychiatric disorder classified by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria, are not always cognizant of their hair-pulling habits and may seek a medical “cure” from dermatologists. Clinic visits can be difficult and lengthy while the physician tries to obtain the history, confirm the diagnosis, and convince the patient of the underlying psychiatric disorder. We report herein a case demonstrating a practical method to confirm the diagnosis of trichotillomania and help the patient understand the extrinsic nature of this condition.

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Figure 2.

Histopathologic findings demonstrating trichomalacia, pigment within hair shafts, and empty hair follicles consistent with trichotillomania (hematoxylin-eosin, original magnification ×10 [A] and ×60 [B]).

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Figure 1.

“Band-Aid sign” demonstrating a linear patch of hair regrowth 2 weeks after punch biopsy corresponding to the area of bandage placement.

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