Post-herpetic neuralgia-associated patchy hair loss closely mimicking trichotillomania

A 52-year-old female experienced patchy hair loss on her scalp and eyebrow due to post-herpetic neuralgia (PHN) following herpes zoster ophthalmicus (HZO), which closely resembled trichotillomania (TTM). The hair loss was caused by constant itching and rubbing over the affected area. Dermoscopic examination ruled out TTM by showing the absence of its classical features. The patient was treated with intralesional therapy, oral medications, and nutritional supplements, leading to an improvement in symptoms. This case highlights the importance of thorough clinical history and dermoscopy to avoid misdiagnosis and unnecessary treatments.