Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of ones own hair. A brief positive feeling may occur as hair is removed. Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress and hair loss can be seen.The disorder may run in families. It occurs more commonly in those with obsessive compulsive disorder. Episodes of pulling may be triggered by anxiety. People usually acknowledge that they pull their hair, and broken hairs may be seen on examination. Other conditions that may present similarly include body dysmorphic disorder; however, in that condition people remove hair to try to improve what they see as a problem in how they look.Treatment is typically with cognitive behavioral therapy. The medication clomipramine may also be helpful, as will keeping fingernails clipped. Trichotillomania is estimated to affect one to four percent of people. Trichotillomania most commonly begins in childhood or adolescence. Women are affected about 10 times more often than men. The name was created by François Henri Hallopeau in 1889, from the Greek θριξ/τριχ; thrix (meaning hair), along with τίλλειν; tíllein (meaning to pull), and μανία; mania (meaning madness). Signs and symptoms
Trichotillomania is usually confined to one or two sites, but can involve multiple sites.
Pseudopterygium is the conjunctival adhesion to cornea caused by limbal or corneal inflammation or trauma. The pseudopterygium can be easily distinguished from pterygium by bowmans probe test. Because of the lack of adherence of pseudopterygium at every point, the probe can be passed beneath it at some point. Causes
Chemical burn
Marginal corneal ulcer
Cicatrizing conjunctivitis
Trauma
Surgery

Differential diagnosis
Treatment
Pseudopterygium can be removed by surgical excision. See also
Symblepharon
Pterygium


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