A 24 years old female presented with patchy hair loss in the right temporal and occipital region. Examination revealed non- scarring alopecia with multiple small broken hairs. Scrapings from scalp showed mild inflammation, peri-follicular hemorrhage and surrounding mild lymphocytic infiltration. What is the most likely diagnosis?
Alopecia areata
Androgenic alopecia
Loose anagen hair
Trichotillomania
Ans: D. Trichotillomania (Ref: Rooks 8/e p55, Fitzputrick 6/e p/55).Patchy hair loss in the right temporal and occipital region in a 24-years-old female non- scarring alopecia with multiple small broken hairs and mild (sparsity) of a perifollicular inflammatory infiltrate is highly suggestive of trichotillomania.