Acquired Non-Scarring Vertex Alopecia in Three Women Revealing Trichotillomania: Diagnostic Accuracy of Trichoscopy

The document presents three cases of trichotillomania, a compulsive hair-pulling disorder, in women of different ages, and highlights the diagnostic accuracy of trichoscopy. The first case is an 18-year-old female with vertex hair loss, the second is a 20-year-old female with a ten-year history of vertex hair loss, and the third is a 58-year-old postmenopausal female with acute alopecia of the vertex. Trichoscopy revealed patterns such as broken hairs at different lengths, flame hairs, black dots, and hair powder, among others. The study concludes that trichoscopy is a sufficient tool in diagnosing trichotillomania when it shows the five most characteristic patterns (hemorrhages, V-sign, hook and coiled hairs, trichoptilosis, and hair powder) associated with a negative pull test. It is also a reliable tool in detecting an added trichotillomania in other hair disorders and should be systematically performed in alopecia.