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Splitting hairs: the ‘hamburger sign’ in trichotillomania
Author(s) -
Royer Michael C.,
Sperling Leonard C.
Publication year - 2006
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.1600-0560.2006.00526.x
Subject(s) - sign (mathematics) , biopsy , pathology , dermatology , skin biopsy , cabello , medicine , mathematical analysis , mathematics , scalp
Background:  A 43‐year‐old male presented with the clinical findings of patchy alopecia that contained persistent hair and re‐growth of hairs of various lengths, consistent with trichotillomania. A biopsy was performed to confirm the diagnosis.. Results:  Histologic evaluation revealed findings consistent with trichotillomania, including trichomalacia. Several hair shafts also showed a vertically oriented split, which contained proteinaceous material and erythrocytes. Morphologically, these were reminiscent of a hamburger within a bun. Conclusions:  The unusual finding reported in this case has not been previously reported. The “hamburger bun sign” provides an additional clue to traumatic injury in the evaluation of biopsies for trichotillomania.

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