Book contents
- Frontmatter
- Contents
- Preface
- Acknowledgments
- Prologue
- Introduction
- 1 The Case of Black Sweat
- 2 A Case of Hives That Wouldn't Go Away
- 3 The Painful Bath
- 4 A Shower of Hives
- 5 A Premenstrual Rash
- 6 Uncombable Hair
- 7 The Man Who Couldn't Sweat
- 8 Scratch Blisters
- 9 Skin Deep Photography
- 10 The Bug That Never Was
- 11 Blue Spots
- 12 White Spots
- 13 Same Place, Next Time Rash
- 14 The Brown Spots That Wouldn't Go Away
- 15 The Case of the Painful Fingertips
- 16 A Strange Sunburn
- 17 A Multiple Personality Dermatitis
- 18 Accidental Hives
- 19 Rotten Fish Odor
- 20 Hormone Blisters
- 21 Flower Shop Itch
- 22 “Stress and a Penny” Hives
- 23 The Case of Unilateral Wrinkles
- 24 Fiery Red Legs
- 25 Painful Feet
- 26 Hot Flashes and Cold Cream
- 27 The Blisters and the Skin Test
- 28 A Chilling Pain
- 29 Rough Skin and Sore Throats
- 30 The Premenstrual Purple Chin
- 31 Nine Year Hives
- 32 Golf Course Dermatitis
- 33 The Secret Message
- 34 Herpes Gladiatorum
- 35 Sunshine Allergy
- 36 L'homme Rouge
- 37 Rings of Rash
- 38 The Breasts That Never Stopped Growing
- 39 The Minister's Hives
- 40 Hardened Skin
- 41 Battery Blisters
- 42 Swollen Lips
- 43 The Worm from Outer Space
- 44 A New Light on Psoriasis
- 45 Black and Blue Spots
- 46 The Emergency Room Itch
- 47 The Sleeper
- 48 A Crazy Rash
- 49 Bald Spots
- 50 The Dog Died
- 51 The Abacus Tumor
- 52 No Spit
- 53 The Smell of Burnt Toast
- 54 The Twenty-Three Year Itch
- 55 The Mysterious Treatment
- 56 The Creeping Acne Cyst
- 57 Our First Case
- 58 A Strange Case of Acne
- 59 The Case of the Glass Eye
- 60 The Hand Eczema Caper
- 61 The Sore That Would Never Heal
- 62 Black Blisters
- References
- Index
33 - The Secret Message
Published online by Cambridge University Press: 23 November 2009
- Frontmatter
- Contents
- Preface
- Acknowledgments
- Prologue
- Introduction
- 1 The Case of Black Sweat
- 2 A Case of Hives That Wouldn't Go Away
- 3 The Painful Bath
- 4 A Shower of Hives
- 5 A Premenstrual Rash
- 6 Uncombable Hair
- 7 The Man Who Couldn't Sweat
- 8 Scratch Blisters
- 9 Skin Deep Photography
- 10 The Bug That Never Was
- 11 Blue Spots
- 12 White Spots
- 13 Same Place, Next Time Rash
- 14 The Brown Spots That Wouldn't Go Away
- 15 The Case of the Painful Fingertips
- 16 A Strange Sunburn
- 17 A Multiple Personality Dermatitis
- 18 Accidental Hives
- 19 Rotten Fish Odor
- 20 Hormone Blisters
- 21 Flower Shop Itch
- 22 “Stress and a Penny” Hives
- 23 The Case of Unilateral Wrinkles
- 24 Fiery Red Legs
- 25 Painful Feet
- 26 Hot Flashes and Cold Cream
- 27 The Blisters and the Skin Test
- 28 A Chilling Pain
- 29 Rough Skin and Sore Throats
- 30 The Premenstrual Purple Chin
- 31 Nine Year Hives
- 32 Golf Course Dermatitis
- 33 The Secret Message
- 34 Herpes Gladiatorum
- 35 Sunshine Allergy
- 36 L'homme Rouge
- 37 Rings of Rash
- 38 The Breasts That Never Stopped Growing
- 39 The Minister's Hives
- 40 Hardened Skin
- 41 Battery Blisters
- 42 Swollen Lips
- 43 The Worm from Outer Space
- 44 A New Light on Psoriasis
- 45 Black and Blue Spots
- 46 The Emergency Room Itch
- 47 The Sleeper
- 48 A Crazy Rash
- 49 Bald Spots
- 50 The Dog Died
- 51 The Abacus Tumor
- 52 No Spit
- 53 The Smell of Burnt Toast
- 54 The Twenty-Three Year Itch
- 55 The Mysterious Treatment
- 56 The Creeping Acne Cyst
- 57 Our First Case
- 58 A Strange Case of Acne
- 59 The Case of the Glass Eye
- 60 The Hand Eczema Caper
- 61 The Sore That Would Never Heal
- 62 Black Blisters
- References
- Index
Summary
“It's her hair,” the mother said as she brought in her fourteen-year-old daughter. What we saw were two stripes of bald skin running across the girl's scalp. Present for two years, they crossed forming a perfect crucifix pattern. It looked as if one had run a hair clipper from the forehead posteriorly to the nape of the neck, and then clipped a 3/4 inch band transversely to form a precise cross. The margins were straight as an arrow, so geometric that we realized it was nothing nature could produce. It had to be the patient.
She was pulling her hair out. It was not the total loss of alopecia areata with its round patterns of totally bald skin. A pluck test showed that her hairs had excellent root strength, and a twist test proved the hairs were not fragile and could not be broken easily. The very short stubble present in the bare areas suggested to us that she would pull the hairs out as soon as they were long enough to grasp with her fingers. Her skin was perfectly normal, and the other doctors she had seen for this problem had found her to be in excellent health on physical and laboratory examinations.
We made the diagnosis of trichotillomania, i.e., hair loss due to the patient pulling out her own hair. It was a nonverbal cry for help. We usually see it in children brought in with the complaint of thinning hair.
- Type
- Chapter
- Information
- Consultations in DermatologyStudies of Orphan and Unique Patients, pp. 104 - 106Publisher: Cambridge University PressPrint publication year: 2006