Trichopsychodermatology: trichotillomania and trichophagia leading to Rapunzel syndrome

Krzysztof Balawender; Anna Pliszka; Klaudia Możdżeń; Michał Kłos; Anna Ogorzałek; Dariusz Boroń; Beniamin O. Grabarek

doi:10.5114/ada.2021.112465

eISSN: 2299-0046
ISSN: 1642-395X

Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii

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4/2022
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abstract:

Original paper

Trichopsychodermatology: trichotillomania and trichophagia leading to Rapunzel syndrome

Krzysztof Balawender

¹

,

Anna Pliszka

¹

,

Klaudia Możdżeń

¹

,

Michał Kłos

¹

,

Anna Ogorzałek

¹

,

Dariusz Boroń

^{2, 3}

,

Beniamin O. Grabarek

^{2, 3}

Morphological Sciences Department of Human Anatomy, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, University of Technology in Katowice, Poland
Department of Gynecology and Obstetrics, Faculty of Medicine in Zabrze, University of Technology in Katowice, Poland

Adv Dermatol Allergol 2022; XXXIX (4): 739-743

DOI: https://doi.org/10.5114/ada.2021.112465

Online publish date: 2022/01/09

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AMA

Balawender K, Pliszka A, Możdżeń K, et al. Trichopsychodermatology: trichotillomania and trichophagia leading to Rapunzel syndrome. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2022;39(4):739-743. doi:10.5114/ada.2021.112465.

APA

Balawender, K., Pliszka, A., Możdżeń, K., Kłos, M., Ogorzałek, A.,  & Boroń, D. et al. (2022). Trichopsychodermatology: trichotillomania and trichophagia leading to Rapunzel syndrome. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 39(4), 739-743. https://doi.org/10.5114/ada.2021.112465

Chicago

Balawender, Krzysztof, Anna Pliszka, Klaudia Możdżeń, Michał Kłos, Anna Ogorzałek, Dariusz Boroń,  and Beniamin O. Grabarek. 2022. "Trichopsychodermatology: trichotillomania and trichophagia leading to Rapunzel syndrome". Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 39 (4): 739-743. doi:10.5114/ada.2021.112465.

Harvard

Balawender, K., Pliszka, A., Możdżeń, K., Kłos, M., Ogorzałek, A., Boroń, D.,  and O. Grabarek, B. (2022). Trichopsychodermatology: trichotillomania and trichophagia leading to Rapunzel syndrome. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 39(4), pp.739-743. https://doi.org/10.5114/ada.2021.112465

MLA

Balawender, Krzysztof et al. "Trichopsychodermatology: trichotillomania and trichophagia leading to Rapunzel syndrome." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, vol. 39, no. 4, 2022, pp. 739-743. doi:10.5114/ada.2021.112465.

Vancouver

Balawender K, Pliszka A, Możdżeń K, Kłos M, Ogorzałek A, Boroń D et al. Trichopsychodermatology: trichotillomania and trichophagia leading to Rapunzel syndrome. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2022;39(4):739-743. doi:10.5114/ada.2021.112465.

Introduction
The Rapunzel syndrome occurs when the trichobezoar (hair ball) extends beyond the small intestine and sometimes even into the colon, producing long, tail-like hair extensions.

Aim: To present cases of trichobezoars, an extremely rare human intestinal disease caused by the ingestion of hair (trichophagia).

Material and methods
In this retrospective study, we assessed the medical records of two patients diagnosed with Rapunzel syndrome admitted to Academic Clinical Hospital No. 2 in Rzeszow, Poland.

Results
The first patient was a 15-year-old girl. The abdominal ultrasound examination revealed an abnormal, non-compressible structure with the approximate dimensions of 12 × 11 cm in the epigastrium, with a strong shadow obscuring the view. Gastroscopy was performed and a tumour sample was taken for histopathological examination, which confirmed the diagnosis of a trichobezoar. The patient’s mother did not agree to her daughter’s psychiatric treatment. The second patient was a 15-year-old girl who reported to the Emergency Room in critical condition due to dehydration and long-term emesis with symptoms of cachexia. Ileotomy with the removal of two trichobezoars with a diameter of about 5 cm and 7 cm was performed. The patient was discharged for treatment at the Mental Health Clinic for trichotillomania.

Conclusions
Trichobezoars give non-specific symptoms that may imitate other diseases for example tumours. Psychotherapy is the recommended treatment and follow-up visits are important in preventing relapses.

keywords:

Trichopsychodermatology: trichotillomania and trichophagia leading to Rapunzel syndrome

Krzysztof Balawender 1 , Anna Pliszka 1 , Klaudia Możdżeń 1 , Michał Kłos 1 , Anna Ogorzałek 1 , Dariusz Boroń 2, 3 , Beniamin O. Grabarek 2, 3

Rapunzel syndrome, non-specific symptoms, diagnosis, psychiatric treatment

Krzysztof Balawender

¹

,

Anna Pliszka

¹

,

Klaudia Możdżeń

¹

,

Michał Kłos

¹

,

Anna Ogorzałek

¹

,

Dariusz Boroń

^{2, 3}

,

Beniamin O. Grabarek

^{2, 3}