拔毛癖1例：双侧眼睫毛脱落

A Case of Trichotillomania with Bilateral Eyelash Loss

摘要: 报道1例拔毛癖，因双侧睫毛脱落半年余就诊。查体示双侧眼睑部睫毛不完全性脱落，脱毛区残留毛干长短不一。皮肤镜检查见长短不一断发、残端分裂及卷曲、黑点征，短发及毳毛增多，未见感叹号发及黄点征。结合病史、临床表现及皮肤镜特征，诊断为拔毛癖。治疗上以行为干预为主，随访示患儿拔毛行为明显减少。本文结合相关文献，对拔毛癖的流行病学、临床特点、皮肤镜表现、鉴别诊断及治疗策略进行讨论，以提高临床识别能力。

Abstract: A case of trichotillomania with bilateral eyelash loss for more than 6 months is reported. Physical examination revealed incomplete loss of the eyelashes on both eyelids, with residual hairs of uneven length in the affected areas. Dermoscopic examination showed hairs of varying lengths, broken hairs with split and curled ends, black dots, and an increased number of short vellus hairs, without exclamation mark hairs or yellow dots. Based on the medical history, clinical manifestations, and dermoscopic findings, a diagnosis of trichotillomania was established. Behavioral intervention was adopted as the main treatment, and follow-up showed a marked reduction in the hair-pulling behavior. In conjunction with a review of the relevant literature, the epidemiology, clinical features, dermoscopic findings, differential diagnosis, and treatment strategies of trichotillomania are discussed to improve clinical recognition of this condition.