Unusual Loss of Body Hair in Childhood: Trichotillomania or Alopecia

The document reported four cases of unusual hair loss in children, highlighting the importance of differentiating between alopecia and trichotillomania due to their distinct management approaches. One child with unilateral eyebrow alopecia improved with topical corticosteroids and tacrolimus. A girl with scalp alopecia progressed to alopecia universalis due to non-compliance with treatment. A boy with alopecia totalis did not respond to any treatments. The fourth child with trichotillomania showed improvement after psychological counseling. The study emphasized that diagnosis and treatment should be based on clinical assessment, psychosocial factors, and exclusion of other disorders, noting that alternative therapies for alopecia totalis or universalis often lack proven efficacy.