Body focused repetitive disorders Quiz: Ace Your Exams

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A 17-year-old girl is brought to the physician by her mother due to recent hair loss. The mother tells the physician that she has noticed a gradual loss of hair on her daughter’s head over the past 3 months. The daughter is embarrassed by her appearance and always tries to cover her hair with a hat. When interviewed alone, the patient tells the physician she sometimes plucks hair off her head. She has tried multiple times to stop this behavior, but she has been unable to do so. She adds that she feels excessive stress before hair pulling that is resolved when she pulls her hair. Which of the following will be most likely seen on microscopic examination of the hair follicles and the scalp of this patient?

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Lymphohistiocytic inflammatory infiltrate in the peri-infundibular region along with miniaturization

Dense lymphocytic infiltrate surrounding the bulbar region of the hair follicle

Periadnexal inflammation with follicular plugging and scarring

Hair in areas of hair loss with varying lengths and various stages of regrowth, without any inflammation or scarring

Subacute dermatitis with follicular destruction associated with a perivascular inflammation and dense neutrophilic infiltration in the dermis