RESUMEN
Abstract: Trichotillomania is considered a behavioral disorder and is characterized by the recurring habit of pulling one's hair, resulting in secondary alopecia. It affects 1% of the adult population, and 2 to 4.4% of psychiatric patients meet the diagnostic criteria. It can occur at any age and is more prevalent in adolescents and females. Its occurrence in childhood is not uncommon and tends to have a more favorable clinical course. The scalp, eyebrows and eyelashes are the most commonly affected sites. Glutamate modulating agents, such as N-acetylcysteine, have been shown to be a promising treatment. N-acetylcysteine acts by reducing oxidative stress and normalizing glutaminergic transmission. In this paper, we report a case of trichotillomania with an excellent response to N-acetylcysteine.
Asunto(s)
Humanos , Masculino , Niño , Acetilcisteína/uso terapéutico , Tricotilomanía/tratamiento farmacológico , Antioxidantes/uso terapéutico , Tricotilomanía/diagnóstico , Diagnóstico Diferencial , Alopecia/diagnóstico , Alopecia/etiologíaRESUMEN
ABSTRACT Trichotillomania is a psychodermatologic disorder characterized by uncontrollable urge to pull one's own hair. Differential diagnoses include the most common forms of alopecia such as alopecia areata. It is usually associated with depression and obsessive-compulsive disorder. Trichotillomania treatment standardization is a gap in the medical literature. Recent studies demonstrated the efficacy of N-acetylcysteine (a glutamate modulator) for the treatment of the disease. We report the clinical case of a 12-year-old female patient who received the initial diagnosis of alopecia areata, but presented with clinical and dermoscopic features of trichotillomania. She was treated with the combination of psychotropic drugs and N-acetylcysteine with good clinical response. Due to the chronic and recurring nature of trichotillomania, more studies need to be conducted for the establishment of a formal treatment algorithm.
Asunto(s)
Humanos , Femenino , Niño , Psicotrópicos/uso terapéutico , Tricotilomanía/diagnóstico , Alopecia Areata/diagnóstico , Pimozida/uso terapéutico , Acetilcisteína/uso terapéutico , Tricotilomanía/tratamiento farmacológico , Fluoxetina/uso terapéutico , Diagnóstico Diferencial , Doxepina/uso terapéuticoAsunto(s)
Adulto , Femenino , Humanos , Antipsicóticos/uso terapéutico , Dibenzotiazepinas/uso terapéutico , Fluoxetina/uso terapéutico , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Tricotilomanía/tratamiento farmacológico , Quimioterapia Combinada , Resultado del TratamientoRESUMEN
Trichotillomania is characterized by recurrent pulling out of one's the case of a 31 years old woman with a 20 years clinical history of trichotillomania who responded favourable to fluoxetine, a serotonin selective reuptake inhibitor
Asunto(s)
Humanos , Femenino , Adulto , Tricotilomanía/diagnóstico , Tricotilomanía/tratamiento farmacológico , Fluoxetina/uso terapéuticoRESUMEN
Há um volume crescente de evidências provenientes da fenomenologia clìnica, incluindo disturbios associados, visualizaçäo do cérebro e estudos neurofarmacológicos, ligando a sìndrome psiquiátrica clássica do distúrbio obsessivo-compulsivo (DOC) a disfunçöes dos glânglios basais e ao sistema serotonìnico. Atualmente, o DOC é a sìndrome psiquiátrica com maior probabilidade de ser originária de uma disfunçäo neurológica especìfica, o que é corroborado por um modelo animal extremamente convincente. Acredita-se que a disfunçäo nos gânglios basais e na alça talâmica cortical frontal produziria os sintomas "positivos" de excesso de preocupaçäo com a higiene pessoal, detalhismo e ambivalência que säo caracterìsticos do DCO. Talvez os dados mais intrigantes sejam os resultados preliminares de ensaios clìnicos, nos quais vários outros comportamentos anormais assemelhados ao excesso de cuidados com a higiene, tanto em animais quanto em humanos, podem estar relacionados ao DOC. Uma perspectiva etológica é sugerida