WordNet
- an irresistible urge to pull out your own hair
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/10/20 03:52:15」(JST)
wiki en
Not to be confused with Trichomoniasis.
| Trichotillomania | |
|---|---|
| Classification and external resources | |
|
A pattern of incomplete hair loss on the scalp of a person with trichotillomania
|
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| ICD-10 | F63.3 |
| ICD-9 | 312.39 |
| DiseasesDB | 29681 |
| MedlinePlus | 001517 |
| eMedicine | derm/433 ped/2298 |
Trichotillomania (pronounced /ˌtrɪkəˌtɪləˈmeɪniə/ TRIK-ə-TIL-ə-MAY-NEE-ə, also known as trichotillosis or hair pulling disorder) is an impulse disorder characterized by the compulsive urge to pull out one's hair, leading to noticeable hair loss and balding, distress, and social or functional impairment.[1] It appears in the ICD chapter 5 on Mental and behavioural disorders and is often chronic and difficult to treat.[2]
Trichotillomania may be present in infants, but the peak age of onset is 9 to 13. It may be triggered by depression or stress. Owing to social implications the disorder is often unreported and it is difficult to accurately predict its prevalence; the lifetime prevalence is estimated to be between 0.6% and 4.0% of the overall population.[1] Common areas for hair to be pulled out are the scalp, eyelashes, eyebrows, legs, arms, hands, nose and the pubic areas.
The name, coined by French dermatologist François Henri Hallopeau,[1] derives from the Greek: trich- (hair), till(en) (to pull), and mania ("madness, frenzy").[3]
Contents
- 1 Classification
- 2 Signs and symptoms
- 3 Causes and pathophysiology
- 4 Diagnosis and screening
- 5 Treatment
- 5.1 Psychotherapy
- 5.2 Medication
- 6 Prognosis
- 7 Epidemiology
- 8 History
- 9 Society and culture
- 10 See also
- 11 References
- 12 External links
Classification
Trichotillomania is defined as a self-induced and recurrent loss of hair.[4] It includes the criterion of an increasing sense of tension before pulling the hair and gratification or relief when pulling the hair.[2] However, some people with trichotillomania do not endorse the inclusion of "rising tension and subsequent pleasure, gratification, or relief" as part of the criteria;[2] because many individuals with trichotillomania may not realize they are pulling their hair, patients presenting for diagnosis may deny the criteria for tension prior to hair pulling or a sense of gratification after hair is pulled.[4]
Trichotillomania may lie on the obsessive-compulsive spectrum,[1] also encompassing obsessive-compulsive disorder (OCD), nail biting (onychophagia) and skin picking (dermatillomania), tic disorders and eating disorders. These conditions may share clinical features, genetic contributions, and possibly treatment response; however, differences between trichotillomania and OCD are present in symptoms, neural function and cognitive profile.[2] In the sense that it is associated with irresistible urges to perform unwanted repetitive behavior, trichotillomania is akin to some of these conditions, and rates of trichotillomania among relatives of OCD patients is higher than expected by chance.[2] However, differences between the disorder and OCD have been noted, including: differing peak ages at onset, rates of comorbidity, gender differences, and neural dysfunction and cognitive profile.[2] When it occurs in early childhood, it can be regarded as a distinct clinical entity.[2]
Because trichotillomania can be present in multiple age groups, it is helpful in terms of prognosis and treatment to approach three distinct subgroups by age: preschool age children, preadolescents to young adults, and adults.[4]
Trichotillomania is often not a focused act, but rather hair pulling occurs in a "trance-like" state;[5] hence, trichotillomania is subdivided into "automatic" versus "focused" hair pulling.[4] Children are more often in the automatic, or unconscious, subtype and may not consciously remember pulling their hair. Other individuals may have focused, or conscious, rituals associated with hair pulling, including seeking specific types of hairs to pull, pulling until the hair feels "just right", or pulling in response to a specific sensation.[4] Knowledge of the subtype is helpful in determining treatment strategies.[4]
Signs and symptoms
Trichotillomania is usually confined to one or two sites,[2] but can involve multiple sites. The scalp is the most common pulling site, followed by the eyebrows, eyelashes, face, arms, and legs.[4] Some less common areas include the pubic area, underarms, beard, and chest.[6] The classic presentation is the "Friar Tuck" form of vertex and crown alopecia.[7] Children are less likely to pull from areas other than the scalp.[4]
People who suffer from trichotillomania often pull only one hair at a time and these hair pull episodes can last for hours at a time. Trichotillomania can go into remission-like states where the individual may not experience the urge to "pull" for days, weeks, months, and even years.[8]
Individuals with trichotillomania exhibit hair of differing lengths; some are broken hairs with blunt ends, some new growth with tapered ends, some broken mid-shaft, or some uneven stubble. Scaling on the scalp is not present, overall hair density is normal, and a hair pull test is negative (the hair does not pull out easily). Hair is often pulled out leaving an unusual shape. Individuals with trichotillomania may be secretive or shameful of the hair pulling behavior.[4]
An additional psychological effect can be low self-esteem, often associated with being shunned by peers and the fear of socializing due to appearance and negative attention they may receive. Some people with trichotillomania wear hats, wigs, false eyelashes, eyebrow pencil, or style their hair in an effort to avoid such attention.[1] There seems to be a strong stress-related component. In low-stress environments, some exhibit no symptoms (known as "pulling") whatsoever. This "pulling" often resumes upon leaving this environment.[9] Some individuals with trichotillomania may feel they are the only person with this problem due to low rates of reporting.[10]
Other medical complications include infection, permanent loss of hair, repetitive stress injury, carpal tunnel syndrome, and gastrointestinal obstruction as a result of trichophagia.[2] In trichophagia, people with trichotillomania also ingest the hair that they pull; in extreme (and rare) cases this can lead to a hair ball (trichobezoar).[4] Rapunzel syndrome, an extreme form of trichobezoar in which the "tail" of the hair ball extends into the intestines, can be fatal if misdiagnosed.[4][11][12][13]
Environment is a large factor which affects hair pulling.[5] Sedentary activities such as being in a relaxed environment are conducive to hair pulling.[5][14] A common example of a sedentary activity promoting hair pulling is lying in a bed while trying to rest or fall asleep.[5] An extreme example of automatic trichotillomania is found when some patients have been observed to pull their hair out while asleep.[5] This is called sleep-isolated trichotillomania.[15]
Causes and pathophysiology
Anxiety, depression and obsessive–compulsive disorder are more frequently encountered in people with trichotillomania.[2][16] Trichotillomania has a high overlap with post traumatic stress disorder, and some cases of trichotillomania may be triggered by stress. Another school of thought emphasizes hair pulling as addictive or negatively reinforcing as it is associated with rising tension beforehand and relief afterward.[2] A neurocognitive model — the notion that the basal ganglia plays a role in habit formation and that the frontal lobes are critical for normally suppressing or inhibiting such habits —sees trichotillomania as a habit disorder.[2]
Abnormalities in the caudate nucleus are noted in OCD, but there is no evidence to support that these abnormalities can also be linked to trichotillomania.[2] One study has shown that individuals with trichotillomania have decreased cerebellar volume.[2][17] These findings suggest some differences between OCD and trichotillomania.[2] There is a lack of structural MRI studies on trichotillomania.[2] In several MRI studies that have been conducted, it has been found that people with trichotillomania have more gray matter in their brains than those who do not suffer from the disorder.[18]
It is likely that multiple genes confer vulnerability to trichotillomania.[2] One study identified mutations in the SLITRK1 gene,[2][19] another identified differences in the serotonin 2A receptor genes,[2][20] and mice with a mutation on the HOXB8 gene showed abnormal behaviors including hair pulling. These data are preliminary, but could indicate a genetic component in trichotillomania.[2][21] The more research that surrounds this relatively newly understood phenomenon, the closer that experts come to determining whether or not it is indeed gene linked.[22]
Diagnosis and screening
Patients may be ashamed or actively attempt to disguise their symptoms. This can make diagnosis difficult as symptoms are not always immediately obvious, or have been deliberately hidden to avoid disclosure.[2] If the patient admits to hair pulling, diagnosis is not difficult; if patients deny hair pulling, a differential diagnosis must be pursued.[4] The differential diagnosis will include evaluation for alopecia areata, iron deficiency, hypothyroidism, tinea capitis, traction alopecia, alopecia mucinosa, thallium poisoning, and loose anagen syndrome.[1][4] In trichotillomania, a hair pull test is negative.[4]
A biopsy can be performed and may be helpful; it reveals traumatized hair follicles with perifollicular hemorrhage, fragmented hair in the dermis, empty follicles, and deformed hair shafts (trichomalacia). Multiple catagen hairs are typically seen. An alternative technique to biopsy, particularly for children, is to shave a part of the involved area and observe for regrowth of normal hairs.[23]
Treatment
Treatment is based on a person's age. Most pre-school age children outgrow it if the condition is managed conservatively. In young adults, establishing the diagnosis and raising awareness of the condition is an important reassurance for the family and patient. Non-pharmacological interventions, including behavior modification programs, may be considered; referrals to psychologists or psychiatrists are considered when other interventions fail. When trichotillomania begins in adulthood, it is often associated with other psychiatric disorders, and referral to a psychologist or psychiatrist for evaluation or treatment is considered best. The hair pulling may resolve when other conditions are treated.[4]
Psychotherapy
Habit reversal training (HRT) has the highest rate of success in treating trichotillomania.[4] HRT has been shown to be a successful adjunct to medication as a way to treat trichotillomania.[2][24] With HRT, the individual is trained to learn to recognize their impulse to pull and also teach them to redirect this impulse. In comparisons of behavioral versus pharmacologic treatment, cognitive behavioral therapy (including HRT) have shown significant improvement over medication alone.[2][4] It has also proven effective in treating children.[4] Biofeedback, cognitive-behavioral methods, and hypnosis may improve symptoms.[25] Acceptance and Commitment Therapy (ACT) is also demonstrating promise in Trichotillomania treatment.[26]
Medication
Medications can be used to treat trichotillomania. Treatment with clomipramine (Anafranil), a tricyclic antidepressant, was shown in a small double-blind study to significantly improve symptoms,[27] but results of other studies on clomipramine for treating trichotillomania have been inconsistent.[4] Naltrexone may be a viable treatment.[28] Fluoxetine (Prozac) and other selective serotonin reuptake inhibitors (SSRIs) have limited usefulness in treating trichotillomania, and can often have significant side effects.[29] Behavioral therapy has proven more effective when compared to fluoxetine or control groups.[4] Dual treatment (behavioral therapy and medication) may provide an advantage in some cases, but robust evidence from high-quality studies is lacking.[2] Acetylcysteine treatment stemmed from an understanding of glutamate's role in regulation of impulse control.[30]
Many medications, depending on individuality, may increase hair pulling.[citation needed]
Prognosis
When it occurs in early childhood (before five years of age), the condition is typically self-limiting and intervention is not required.[2] In adults, the onset of trichotillomania may be secondary to underlying psychiatric disturbances and symptoms are generally more long-term.[4]
Secondary infections may occur due to picking and scratching, but other complications are rare.[4] Individuals with trichotillomania often find that support groups are helpful in living with and overcoming the disorder.[4]
Epidemiology
Although no broad-based population epidemiologic studies had been conducted as of 2009, the lifetime prevalence of trichotillomania is estimated to be between 0.6% and 4.0% of the overall population.[1] With a 1% prevalence rate, 2.5 million people in the U.S. may have trichotillomania at some time during their lifetimes.[14]
Trichotillomania is diagnosed in all age groups; onset is more common during preadolescence and young adulthood, with mean age of onset between 9 and 13 years of age,[4] and a notable peak at 12–13.[2] Among preschool children the genders are equally represented; there appears to be a female predominance among preadolescents to young adults, with between 70% and 93% of patients being female.[4] Among adults, females typically outnumber males by 3 to 1.[2]
"Automatic" pulling occurs in approximately three-quarters of adult patients with trichotillomania.[4]
History
Hair pulling was first described in the literature in 1885,[3] and the term trichotillomania was coined by the French dermatologist François Henri Hallopeau in 1889.[1][2]
In 1987, trichotillomania was recognized in the Diagnostic and Statistical Manual of the American Psychiatric Association, third edition-revised (DSM-III-R).[31]
Society and culture
Support groups and internet sites can provide recommended educational material and help persons with trich in maintaining a positive attitude and overcoming the fear of being alone with the disease.[2][4]
A documentary film exploring trichotillomania, Bad Hair Life, was the 2003 winner of the International Health & Medical Media Award for best film in psychiatry and the winner of the 2004 Superfest Film Festival Merit Award.[32][33][34]
Trichster is a documentary that follows seven individuals living with trichotillomania, as they navigate the complicated emotions surrounding the disorder, and the effect it has on their daily lives. The film is slated for completion in 2014.[35][36]
On January 10, 2011 the TLC television show My Strange Addiction showcased Haley, a woman who lives with trichotillomania.
A character in the movie The Internship suffers from trichotillomania.[citation needed] He is seen pulling out hair from his right eyebrow during sections of the movie.
Mavis Gary (Charlize Theron) in the film Young Adult suffers from trichotillomania.[37]
The mother of the heroine in Gillian Fynn's Sharp Objects suffers from trichotillomania.
Rebecca Brown, a YouTuber who goes by the usernames Beckie0 and TrichJournal, actively talks about her experiences with trichotillomania.[38]
See also
- Body-focused repetitive behavior
- Dermatillomania (compulsive skin picking)
- Onychophagia (compulsive nail biting)
- Dermatophagia (compulsive biting of the skin, particularly around the fingernails)
- Noncicatricial alopecia
- Psychogenic alopecia, a form of baldness that is caused by excessive grooming in cats.
References
- Notes
- ^ a b c d e f g h Huynh M, Gavino AC, Magid M (June 2013). "Trichotillomania". Semin Cutan Med Surg 32 (2): 88–94. PMID 24049966.
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac Chamberlain SR, Menzies L, Sahakian BJ, Fineberg NA (April 2007). "Lifting the veil on trichotillomania". Am J Psychiatry 164 (4): 568–74. doi:10.1176/appi.ajp.164.4.568. PMID 17403968.
- ^ a b Salaam K, Carr J, Grewal H, Sholevar E, Baron D (2005). "Untreated trichotillomania and trichophagia: surgical emergency in a teenage girl". Psychosomatics 46 (4): 362–6. doi:10.1176/appi.psy.46.4.362. PMID 16000680.
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa Sah DE, Koo J, Price VH (2008). "Trichotillomania" (PDF). Dermatol Ther 21 (1): 13–21. doi:10.1111/j.1529-8019.2008.00165.x. PMID 18318881.
- ^ a b c d e Tay YK, Levy ML, Metry DW (May 2004). "Trichotillomania in childhood: case series and review". Pediatrics 113 (5): e494–8. doi:10.1542/peds.113.5.e494. PMID 15121993.
- ^ TLC. "What is Compulsive Hair Pulling" http://www.trich.org/about/hair-pulling.html. 2012
- ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Saunders. p. 62. ISBN 0-7216-2921-0.
- ^ "Trichotillomania: 12 Facts You Should Know About Trich". Pullfreeatlast.com. Retrieved 2013-02-22.
- ^ Christenson GA, Mackenzie TB, Mitchell JE (1991). "Characteristics of 60 adult chronic hair pullers". The American Journal of Psychiatry 148 (3): 365–70. PMID 1992841.
- ^ Christenson GA, MacKenzie TB, Mitchell JE (1994). "Adult men and women with trichotillomania. A comparison of male and female characteristics". Psychosomatics 35 (2): 142–9. doi:10.1016/S0033-3182(94)71788-6. PMID 8171173.
- ^ Ventura DE, Herbella FA, Schettini ST, Delmonte C (2005). "Rapunzel syndrome with a fatal outcome in a neglected child". J. Pediatr. Surg. 40 (10): 1665–7. doi:10.1016/j.jpedsurg.2005.06.038. PMID 16227005.
- ^ Pul N, Pul M (1996). "The Rapunzel syndrome (trichobezoar) causing gastric perforation in a child: a case report". Eur. J. Pediatr. 155 (1): 18–9. doi:10.1007/bf02115620. PMID 8750804.
- ^ Matejů E, Duchanová S, Kovac P, Moravanský N, Spitz DJ (September 2009). "Fatal case of Rapunzel syndrome in neglected child". Forensic Sci. Int. 190 (1–3): e5–7. doi:10.1016/j.forsciint.2009.05.008. PMID 19505779.
- ^ a b Diefenbach GJ, Mouton-Odum S, Stanley MA (November 2002). "Affective correlates of trichotillomania". Behav Res Ther 40 (11): 1305–15. doi:10.1016/S0005-7967(02)00006-2. PMID 12384325.
- ^ "What is Trichotillomania?". Retrieved August 20, 2010.
- ^ Christenson GA, Crow SJ (1996). "The characterization and treatment of trichotillomania". The Journal of clinical psychiatry. 57 Suppl 8: 42–7; discussion 48–9. PMID 8698680.
- ^ Keuthen NJ, Makris N, Schlerf JE, et al. (2007). "Evidence for reduced cerebellar volumes in trichotillomania". Biol. Psychiatry 61 (3): 374–81. doi:10.1016/j.biopsych.2006.06.013. PMID 16945351.
- ^ "Grey matter abnormalities in trichotillomania: morphometric magnetic resonance imaging study". Bjp.rcpsych.org. Retrieved 2013-02-22.
- ^ Zuchner S, Cuccaro ML, Tran-Viet KN, et al. (October 2006). "SLITRK1 mutations in trichotillomania". Mol. Psychiatry 11 (10): 887–9. doi:10.1038/sj.mp.4001865. PMID 17003809. Lay summary – BBC News (September 29, 2006).
- ^ Hemmings SM, Kinnear CJ, Lochner C, et al. (2006). "Genetic correlates in trichotillomania--A case-control association study in the South African Caucasian population". Isr J Psychiatry Relat Sci 43 (2): 93–101. PMID 16910371.
- ^ Greer JM, Capecchi MR (January 2002). "Hoxb8 is required for normal grooming behavior in mice". Neuron 33 (1): 23–34. doi:10.1016/S0896-6273(01)00564-5. PMID 11779477.
- ^ [1][dead link]
- ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Saunders. p. 63. ISBN 0-7216-2921-0.
- ^ Woods DW, Wetterneck CT, Flessner CA (2006). "A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania". Behaviour research and therapy 44 (5): 639–56. doi:10.1016/j.brat.2005.05.006. PMID 16039603.
- ^ Shenefelt PD (2003). "Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind?". Dermatol Ther 16 (2): 114–22. doi:10.1046/j.1529-8019.2003.01620.x. PMID 12919113.
- ^ Ruiz, F. J. (2010). "A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies". International Journal of Psychology and Psychological Therapy 10 (1): 125–62.
- ^ Swedo SE, Leonard HL, Rapoport JL, Lenane MC, Goldberger EL, Cheslow DL (1989). "A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling)". N. Engl. J. Med. 321 (8): 497–501. doi:10.1056/NEJM198908243210803. PMID 2761586.
- ^ A.D.A.M. Medical Encyclopedia. Trichotillomania Trichotillosis; Compulsive hair pulling. Last reviewed: February 13, 2012.
- ^ Christenson GA, Mackenzie TB, Mitchell JE, Callies AL (November 1991). "A placebo-controlled, double-blind crossover study of fluoxetine in trichotillomania". Am J Psychiatry 148 (11): 1566–71. PMID 1928474.
- ^ Grant, J. E.; Odlaug, B. L.; Won Kim, S. (2009). "N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania: A Double-blind, Placebo-Controlled Study". Archives of General Psychiatry 66 (7): 756–63. doi:10.1001/archgenpsychiatry.2009.60. PMID 19581567.
- ^ "Trichobezoars in Trichotillomania: Case Report and Literatur...". Psychosomatic Medicine. Retrieved 2014-04-10.
- ^ "Bad Hair Life: A Documentary". Trichotillomania Learning Center. Retrieved November 27, 2009.
- ^ "Superfest XXIV Winners". CDT Inc. Retrieved November 27, 2009.
- ^ "Hannah Sussman’s Art Imitates Life Join Her For a Screening October 3rd". Century City News. September 28, 2009. Retrieved November 27, 2009.
- ^ "About The Film". Trichster. Retrieved 2014-04-10.
- ^ Koning, Patricia (2012-07-27). "Documentary Film Project to Portray Living with Trichotillomania - The Independent: Community". Independentnews.com. Retrieved 2014-04-10.
- ^ Haglund, David (2011-12-20). "In Young Adult, Charlize Theron Isn’t "Unlikable," She’s Mentally Ill". Slate.com. Retrieved 2014-04-10.
- ^ "TrichJournal on YouTube by Beckie0".
- Further reading
- Hennerberg, Gary (2009) Urges: Hope and Inspiration for People with Trichotillomania; Doses of Comfort Publishing, ISBN 978-1-4486-9083-1
- Foxwell, Amy (2011) How to Stop Pulling Out Your Hair; Victoire Publishing, ISBN 1480288950
External links
- Trichotillomania at DMOZ
- "Trichotillomania: Out of the Closet," Psychiatric Times
- Trichotillomania Learning Center
- "Trichotillomania Resource Centre"
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UpToDate Contents
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- 1. 皮膚むしり症（かきむしり）および関連疾患 skin picking excoriation disorder and related disorders
- 2. 円形脱毛症の臨床症状および診断 clinical manifestations and diagnosis of alopecia areata
- 3. 頭部白癬 tinea capitis
- 4. 醜形恐怖症：評価、診断、鑑別診断 body dysmorphic disorder assessment diagnosis and differential diagnosis
- 5. 脱毛の評価および診断 evaluation and diagnosis of hair loss
English Journal
- Family functioning in paediatric obsessive compulsive and related disorders.
- Murphy YE1, Flessner CA1.
- The British journal of clinical psychology / the British Psychological Society.Br J Clin Psychol.2015 Nov;54(4):414-34. doi: 10.1111/bjc.12088. Epub 2015 May 28.
- OBJECTIVE: Research among youths with obsessive compulsive disorder (OCD) has shown a significant relationship between illness severity, treatment outcome, and the family environment yet little work has been undertaken among the broader class of obsessive compulsive and related disorders (OCRDs) - T
- PMID 26017183
- LONG-TERM OUTCOME IN PEDIATRIC TRICHOTILLOMANIA.
- Schumer MC1, Panza KE2, Mulqueen JM1, Jakubovski E1, Bloch MH1,3.
- Depression and anxiety.Depress Anxiety.2015 Oct;32(10):737-43. doi: 10.1002/da.22390. Epub 2015 Jul 2.
- OBJECTIVE: To examine long-term outcome in children with trichotillomania.METHOD: We conducted follow-up clinical assessments an average of 2.8 ± 0.8 years after baseline evaluation in 30 of 39 children who previously participated in a randomized, double-blind, placebo-controlled trial of N-acetylc
- PMID 26139231
- Obsessive-compulsive disorder in dermatology.
- Mavrogiorgou P1, Bader A2, Stockfleth E2, Juckel G1.
- Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG.J Dtsch Dermatol Ges.2015 Oct;13(10):991-9. doi: 10.1111/ddg.12781.
- Patients with obsessive-compulsive (OCD) and related disorders - primarily trichotillomania, body dysmorphic disorder, and skin picking disorder - frequently present to dermatologists due to associated hair and skin symptoms. It is therefore crucial that dermatologists be familiar with these disorde
- PMID 26408459
Japanese Journal
- Obsessive-Compulsive and Related Disorders (強迫症および関連症/強迫性障害および関連障害群) (特集 DSM-5 : 児童精神科領域はどう変わったのか?変わるのか?)
- 小平 雅基
- 児童青年精神医学とその近接領域 55(5), 568-578, 2014
- NAID 40020326367
- 抜毛癖の子どもの臨床像と情緒行動特性の関連 : CBCL教師版(TRF)を用いた検討
- 片桐 由紀子
- 児童青年精神医学とその近接領域 55(1), 45-54, 2014
- NAID 40020027350
- 腸閉塞をきたした重複毛髪胃石の1例
- 松下 英信,佐藤 雄介,武田 重臣,川瀬 義久
- 日本腹部救急医学会雑誌 34(3), 723-725, 2014
- 毛髪胃石とは，経口的に摂取された毛髪に胃液が作用して固形物となったものであり比較的まれな疾患である。今回，われわれはさらにまれな腸閉塞をきたした重複毛髪胃石の症例を経験したので報告する。症例は12歳の女児で，5日前からの腹痛・嘔吐を主訴に近医を受診し，胃腸炎の診断にて様子をみるも軽快せず，当院へ紹介され受診した。腸閉塞の診断で，当院小児科に入院となった。イレウス管を挿入し保存的治療を行うも症状改善 …
- NAID 130004890829
Related Links
- Trichotillomania is a condition that gives people strong urges to pull out their hair. What causes it and how do people overcome it? Find out in this article. ... Daria used to make up excuses for the bald spot on the back of her head ...
- dear-trich
Related Pictures
★リンクテーブル★
| リンク元 | 「KAP STEP2CK2008 002」「トリコチロマニー」「毛髪抜去癖」「抜毛症」 |
「KAP STEP2CK2008 002」
glossary
- lancinating
- throbbing
- hilar lymphadenopathy
- vitiligo
- alopecia areata 円形脱毛症
- trichotillomania
- psyllium おおばこか オオバコ。緩下薬らしい
- Coxsackie virus 手足口病
- indolent 無痛性
- commensals 共生
- actinomycetes 放線菌
サルコイドーシス
- 疫学
- peak age group for sarcoidosis is 20-40
- more common in blacks
- African Americanがヒント
病態
- lungs, heart, kidneys, skin, liver, or other organ
- uveitisも来す？
- 冒されやすい部位は皮膚、眼、肺
亜急性甲状腺炎
- 病原体：ウイルス
橋本病
- Many patients also have other autoimmune diseases.
- ホルモンの変化：hypothyroidism are also present in longer-standing cases. Early in the disease, as in this case, T4 and TSH levels may be normal.
- MPO抗体は橋本病に特異的ではない；Graves disease and silent lymphocytic thyroiditisでも上がる
円形脱毛症
- 円形脱毛症と他の疾患の関連：autoimmune disorders, such as Hashimoto thyroiditis, pernicious anemia, and Addison disease
- 皮膚科的特徴：exclamation hair
- 治療：triamcinolone or application of anthralin ointment has been beneficial in hastening recovery
プロペシア
- フィナステリドは、5α-還元酵素II型を選択的に抑制することによりテストステロンからジヒドロテストステロンへの変換を阻害し、発毛作用を示すものと考えられる。
同名半盲
- bilateral temporal hemianopia and is due to chiasmatic lesions that compromise the crossing fibers originating from the temporal retina
単純ヘルペスウイルスの初感染患者について
- Gingivostomatitis and pharyngitis are the most frequent clinical manifestations of primary herpes simplex virus 1 infection, and are most commonly seen in children and young adults. Clinical signs and symptoms include fever, malaise, myalgias, and cervical adenopathy. Common lesions may involve the hard and soft palate, gingiva, tongue, lips, and facial area.
放線菌について
- Actinomyces israelii causes an indolent suppurative infection.
「トリコチロマニー」
- 英
- trichotillomania
- 同
- 抜毛症、抜毛癖、毛髪痒感狂
「毛髪抜去癖」
「抜毛症」
- 英
- trichotillomania
- 同
- 抜毛癖
- 関
- トリコチロマニー