A mother brings her 10-year-old daughter into the clinic for an examination of the scalp and hair. She states that the child has developed irregularly shaped patches with broken-off, stublike hair in some places; she is worried that this condition could be some form of premature baldness. What is the best response by the nurse?

A) "This looks like folliculitis which can be treated with an antibiotic."
B) "This sounds like traumatic alopecia which can be treated with antifungal medications."
C) "This appears to be tinea capitis which is highly contagious and needs immediate attention."
D) "This appears to be trichotillomania. Does your daughter have a habit of absentmindedly twirling her hair?"

Trichotillomania, self-induced hair loss, is usually due to habit. It forms irregularly shaped patches with broken-off, stublike hairs of varying lengths. A person is never completely bald. It occurs as a child absentmindedly rubs or twirls the area while falling asleep, reading, or watching television. Folliculitis is inflammation of hair follicles which causes a pustule with a hair visible in the center. Traumatic alopecia is not a real term. Traction alopecia is hair loss along the hairline, part in the hair or scattered that is caused by trauma such as tight braids, ponytails, barretts, cornrows, and hair weaves. Tinea capitis is rounded patchy hair loss on the scalp, leaving broken-off hairs, pustules, and scales on the skin, and is caused by a fungal infection. Tinea capitis is highly contagious.