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ASDP: Scalp Biopsies Help Diagnose Trichotillomania By Alison Palkhivala Special to DG News PHOENIX, AZ -- October 13, 2002 -- Scalp biopsies are a useful tool for the diagnosis trichotillomania. Wilma Bergfeld, MD, from the department of dermatology and colleagues from the Cleveland Clinic Foundation, in Cleveland, Ohio, United States, determined whether scalp biopsy could be helpful in the diagnosis of trichotillomania. Trichotillomania is a difficult condition to diagnose because it can mimic other diseases, and patients rarely disclose their hair pulling behaviour. Dr. Bergfeld and colleagues examined 28 scalp biopsies from 26 patients who had been diagnosed with trichotillomania, based on both histopathological and clinical evidence. They presented their findings here October 11 at the annual meeting of the American Society of Dermatopathology (ASDP). Patients were aged 13 to 78, with a mean age of 42. All but 2 were female, and trichotillomania was chronic in all cases. Among these patients, the most common histologic findings were follicular plugging in 96 percent of patients, decreased total number of follicles in 96 percent, reversed anagen:telogen ratio in 86 percent and melanoderma in 65 percent of patients. Two features commonly reported to be specifically associated with trichotillomania are the presence of trichomalacia and pigmented casts, found in 57 percent and 36 percent of this patient population, respectively. According to the authors, "scalp biopsies are valuable in the diagnosis of trichotillomania." E-mail this page to a friend or colleague! To print, use this version