Monotonous Broom Hairs: A Feature of Trichoteiromania

Abstract

Trichoteiromania is a self-inflicted traumatic hair injury, with breaking of the hair shafts resulting from repetitive rubbing of the scalp. We describe a patient with trichoteiromania presenting with one lichenified pruriginous plaque on the scalp, associated with fracture and loss of hair shafts giving the conspicuous appearance of monotonous clusters of broom hairs under trichoscopy, which pointed to the diagnosis. As trichoteiromania can be considered a psychodermatological condition, patient education and a behavioral approach are of paramount importance in the management and prognosis of this disorder.

Trichoscopic diagnosis and management of a case of scalp dysesthesia with lichen simplex chronicus

“…[ 6 ] Broom hairs were recently considered a hallmark finding in trichoteiromania which is a compulsive disorder of rubbing of hair. [ 7 8 ] Fowler and Tosti[ 9 ] reported a case of frictional alopecia presenting as trichorrhexis nodosa on trichoscopy. Even though the pathogenesis of SD, trichoteiromania and frictional alopecia differ, they all have a similar mechanism of injury to hair.…”

Localized alopecia with itching on the scalp

“…Trichoscopy is a useful tool in the diagnosis of lichen simplex chronicus (LSC) of the scalp, which typically shows broom hairs, associated with scaling and background erythema. 1 Conditions associated with trichoteiromania and scalp dysesthesia can be associated with features such as broom hairs, trichoptilosis and trichorrhexis. Broom hairs are thought to result from the continuous friction leading to erosion of the adherent distal cuticular cell margin.…”

A fallen‐snow pattern of hair in trichoteiromania

“…Previously, broom hairs have been reported as a hallmark of trichotemnomania. 5 Dermoscopy is very valuable for trichotemnomania diagnosis. 4 In addition to broom hairs, the individual bifurcated hairs here, had a dandelion-like morphology owing to different refraction, and presented overall as the 'fallen snow pattern'.…”

“…Another noteworthy fact is that our patient was HIV negative. So far, specific lesions have only been documented in tattooed patients with cutaneous leishmaniasis and HIV, 4,5 particularly in Spain as N. Kluger pointed out. 6 Therefore, this might be the…”