A Case of Trichotillomania Presenting as a Factitious Ulcer
January 2023
in “
Odisha Journal of Psychiatry
”
Studysummary This case study describes a patient initially misdiagnosed with pediculosis capitis, later identified as having trichotillomania, highlighting the importance of thorough behavioral inquiries by physicians in such cases.
Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
A 30-year-old woman with trichotillomania presented with a nonhealing scalp ulcer after initially seeking dermatological treatment. Despite using antibiotics and ointments, her condition persisted. Upon psychiatric evaluation, she admitted to hair-pulling triggered by stress, leading to temporary relief. She exhibited moderate depressive and anxiety symptoms, scoring 17 on the Hamilton Depression Rating Scale and 14 on the Hamilton Anxiety Rating Scale. Treatment included clomipramine, N-acetylcysteine, and habit reversal training, which improved her symptoms. The case underscores the importance of a multidisciplinary approach and awareness in diagnosing and treating trichotillomania, especially when patients are unaware or uncooperative.
