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KMID : 0363220210590100778
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Korean Journal of Dermatology
2021 Volume.59 No. 10 p.778 ~ p.784
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A Clinical Study of Trichotillomania in 198 Cases: An Update and Cross-Time Comparison
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Lim Ji-Hoon
Kim Ki-Hun
Kwon Soon-Hyo
Sim Woo-Young
Lew Bark-Lynn
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Abstract
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Background: Trichotillomania (TTM) is characterized by recurrent hair pulling, resulting in hair loss. TTM is typically encountered in dermatology settings; however, few reports on the clinical characteristics of TTM in a large population are available.
Objective: To evaluate the clinical characteristics of TTM.
Methods: We performed a retrospective chart review of patients diagnosed with TTM between 2006 and 2019.
Results: Clinical records of 198 patients were analyzed. The average age of TTM onset was 10.8 years, and 119 patients experienced childhood-onset (at ＜12 years). Sex prevalence showed a female predominance, and the proportion of females was lower in the childhood-onset TTM than in the late-onset TTM (onset at ≥12 years). Vertex was the most commonly involved site. A history of stressful situations was noted in 48 patients (24.2%). In the group with a poor prognosis, the number of patients with ≥25% scalp invasion was significantly more than the other group. The average duration of hair loss to more than 50% recovery was 4.88 months for childhood-onset TTM cases and 9.83 months for late-onset TTM cases. The prognosis was significantly better in the childhood-onset TTM than in the late-onset TTM. Nail biting and folliculitis were the most common co-occurring repetitive behavior and comorbid disease, respectively.
Conclusion: Unlike previous domestic studies, patients with childhood-onset TTM had a female preponderance. Moreover, the proportion of patients who experienced a stressful situation was higher than that reported in a previous study. In addition, patients with severe disease and late-onset TTM had a significantly poorer prognosis.
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KEYWORD
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Epidemiology, Trichotillomania
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