• Giuseppe Micali
  • Anna Elisa Verzì
  • Federica Dall’Oglio
  • Francesco Lacarrubba


Trichotillomania is an obsessive-compulsive disorder that frequently occurs in early childhood and adolescence. It is characterized by single or multiple, ill-defined patches of incomplete alopecia due to patient’s repetitive self-pulling of hair. In most cases, the clinical diagnosis may be challenging and dermatoscopy may be very helpful, showing the presence of multiple hairs broken at different lengths and fraying of the extremities. According to their appearance, broken hairs have variably been described and named (i.e., flame hairs, coiled hairs, tulip hairs, and V-sign). Regrowing hairs generally coexist with features of ongoing hair pulling.


Trichotillomania Hair loss Alopecia Broken hairs Flame hairs Coiled hairs Tulip hairs V-sign 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Giuseppe Micali
    • 1
  • Anna Elisa Verzì
    • 1
  • Federica Dall’Oglio
    • 1
  • Francesco Lacarrubba
    • 1
  1. 1.Dermatology ClinicUniversity of CataniaCataniaItaly

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