Demet ÖYEKÇİN GÜLEÇ, ERKAN MELİH ŞAHİN, Mehmet Murat DEMET

The child who pulls his little brothers' hair: a different trichotillomania case

Trikotillomani, çocukluk çağı alopesi nedenlerinden biridir. Sunmuş olduğumuz olgu, 8 yaşında olup, yaklaşık 4 yıldır süren saç yolma, tırnak yeme, burun karıştırma, tırnak yolma ve saç derisini koparma yakınmaları ile getirilmiştir. Saç bölgesinin özellikle frontal ve verteks kısmının etkilendiği gözlenmiştir. Olgunun saçlarını infantil dönemde yolmaya başladığı ve kronik, düzelmeyen bir gidişinin olduğu öğrenilmiştir. Son 2 yıldır, kendisinden küçük iki kardeşinin saçını yolmaya başladığı ve sıklıkla birlikte oyun oynarken veya kardeşleri uyurken saçlarını yolduğu belirtilmiştir. Her iki erkek kardeşinin saçlı derisinde alopesi gözlenmiştir. Evde sıklıkla kavga, şiddet ve olumsuz davranışların olduğu öğrenilmiştir. Literatürde kardeşlerinin saçını yolan vaka sayısı oldukça seyrektir. Çocukluk çağında yaşanan travma, fiziksel ve duygusal ihmalin ve olumsuz etkilenmiş olan anne-çocuk ilişkisinin bu vakada ortaya çıkan trikotillomani için önemli etmenler olduğu düşünülmüştür. Çocukluk çağı trikotillomani olgularında kardeşler üzerinde herhangi bir belirtinin olup olmadığının araştırılması önemlidir.

Kardeşlerinin saçını yolan farklı bir trikotillomani olgusu

Trichotillomania (TTM) is a relatively common cause of childhood alopecia. We report our observations of 8 year old boy referred for consultation for a 4 year history of hair pulling, nail-biting, nose picking, nail picking and scalp-picking. The most commonly affected sites on the scalp were frontal region and vertex. He had started pulling his hair when he was an infant and had a very chronic, unremitting course. During the last two years, he began to pull his two little brothers hair when they were playing together or when they were sleeping. Both of his both brothers had alopecia on their scalp. It was discovered that there were frequent arguments, violence and negative behaviors at home. Few cases are reported in the literature about children who pull their siblings hair. We considered that impaired affective interpersonal communication between mother and child, physical and emotional neglect and childhood trauma might have played a role in the development of TTM for this case. In childhood trichotillomania cases, it is important to investigate whether the siblings have hair loss.

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