Rising Tension Beforehand in Medicine / Internal Medicine — 54yo Man | Psychiatry | SMLE Q#11028
SMLE Question #11028
Medicine / Internal Medicine
Psychiatry
Objective: OBJ-253
Last updated: February 2026
A 54-year-old man has progressive hair loss for 6 months. He describes recurrent, stress-related urges to pull hair from his scalp and eyebrows, with rising tension beforehand and brief relief afterward, followed by guilt and distress. Examination shows irregular patchy alopecia with broken hairs of varying lengths; the scalp skin appears normal without erythema or scarring, and eyelashes are sparse. What is the most likely diagnosis?
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