P10   TRICHOTILLOMANIA WITH SEASONAL APPEARANCE RESULTING IN A TRICHOBEZOAR

De Donno A., Titzmann T., Balda B.-R. Dept. of Dermatology, Klinikum Augsburg, Germany.

Trichotillomania was diagnosed in an eleven-year-old girl. She lamented a complete effluvium of the whole upper parietal and frontal scalp with a normal coat of hair in the lower parietal parts and in the occipital region. The loss of tuft of hair was mainly in the winter seasons with a complete normalization in spring and summer. The first diagnosis of infection-releated alopecia areata made by an outside dermatologist led to tonsillectomy and polypectomy as well as multiple antibiotical treatments because of chronic sinusitis maxillaris.

The histological examination of the scalp showed the characteristics of trichotillomania with wriggled hair follicles and trichomalazia.

Our recommendation of psychotherapy was totally refused by the father and the step-mother of the young patient.

Few months after the first visit in our department the trichotillomania resulted in a surgical intervention because of a trichobezoar.