Trichotemnomania: obsessive-compulsive habit of cutting or shaving the hair.

A 28-year-old woman presented with a completely hairless scalp. The disorder had started 1 year ago, and at the same time she had developed dysphonia. During the past year, her hair disease had been diagnosed as alopecia areata totalis by many specialists, including several dermatologists. A close inspection of her scalp, however, revealed that no alopecia was present, because all infundibula were filled with a hair shaft that, on microscopic examination, showed cleanly cut surfaces. A scalp biopsy specimen showed completely normal structures. The pubic area was found to be covered with hair stubs of the same length. Therefore, a diagnosis of trichotemnomania was made. This term is derived from Greek thrix (hair), temnein (to cut), and mania (madness). After a stressful life event, the patient had developed both psychogenic dysphonia and the compulsive habit to remove the hair of her scalp, eyebrows, and axillary and pubic areas by shaving. Trichotemnomania is a distinct obsessive-compulsive disorder that should not be confused with trichotillomania. The condition should be taken into account when a supposed alopecia areata looks somewhat unusual.