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Isolated Eyebrows and Eyelashes Trichoteiromania Mimicking Alopecia Areata

Isolated Eyebrows and Eyelashes Trichoteiromania Mimicking Alopecia Areata

Khadija Elboukhari1*, Hanane Baybay1, Fatima Zahra Mernissi1

Journal Title:Journal of Dermatology Research

A 23-year-old woman, with no pathological history, was treated for alleged alopecia areata of her eyebrows and eyelashes by her usual dermatologist before being referred to our institution after treatment failure. The condition had been endured for almost two years. The affected areas were also itchy. The patient has no history of autoimmune diseases. Our clinical examination found isolated alopecia of the eyebrows and eyelids, with hair rarefaction (Fig. 1). The pull-hair test sign was negative. The rest of the hair examination of the scalp, pubis, armpits, and body duvet was without abnormalities. The nails were respected. For the alopecia, our differential diagnoses included alopecia areata, frontal fibrosing alopecia, and trichotillomania. Dermoscopic examination revealed erythema. There was no cadaveric or vellus hair and we did not find any yellow dot. Further dermoscopic analyses revealed blacks dots of different sizes, with some brushed hairs and one hook-like end hairs (Fig. 2). The patient admitted her habits of rubbing and scratching her eyebrows and eyelashes. Our final diagnosis was trichotillomania. We commenced treatment with N-acetylcysteine and a psychological evaluation.