A Case of Atopic Dermatitis Complicated with Scratched Alopecia

-Shifting from trichotillomania to scratched alopecia-

Abstract

A nine-year-old boy who had been receiving treatment for mild atopic dermatitis at his local clinic was referred to our department because of alopecia on the left side of the head, which had developed one month before the initial visit to our department. Because his band-like alopecia was not accompanied by itching and had residual ruptured short hair, with the patient unconsciously pulling out his hair, a diagnosis of trichotillomania was made. A detailed examination by interview showed that he was under stress due to being forced to keep goal during soccer practice in after-school care for children. His parent consulted a person in charge of afterschool care for children, and three months later his condition nearly recovered. After that, the atopic dermatitis worsened due to sweating, and itching of the frontal region and both sides of the head caused scratched alopecia. Although the patient underwent topical steroid treatment, the symptom was refractory to the treatment. Thus, a photographic record of the alopecia on both sides of the head was made to have him see the affected parts objectively at every visit. As a result, he was cured of the disease in approximately eight months.Skin Research, Suppl. 18: 61-64, 2012