The man with the purple nostrils: a case of rhinotrichotillomania secondary to body dysmorphic disorder
Article first published online: 23 OCT 2002
Acta Psychiatrica Scandinavica
Volume 106, Issue 6, pages 464–466, December 2002
How to Cite
Fontenelle, L. F., Mendlowicz, M. V., Mussi, T. C., Marques, C. and Versiani, M. (2002), The man with the purple nostrils: a case of rhinotrichotillomania secondary to body dysmorphic disorder. Acta Psychiatrica Scandinavica, 106: 464–466. doi: 10.1034/j.1600-0447.2002.01463.x
- Issue published online: 23 OCT 2002
- Article first published online: 23 OCT 2002
- Accepted for publication June 10, 2002
- impulse control disorders;
- impulsive behavior;
- obsessive-compulsive disorder;
Objective: To describe a different type of self-injurious behavior that may be secondary to body dysmorphic disorder (BDD).
Method: Single case report.
Results: We reported a case of an individual who have developed the self-destructive habit of pulling and severely scraping hairs and debris out of the mucous membrane of his nasal cavities. We have proposed the term rhinotrichotillomania to emphasize the phenomenological overlapping between trichotillomania (TTM) and rhinotillexomania (RTM) exhibited by this case. The main motivation behind the patient's actions was a distressing preoccupation with an imaginary defect in his appearance, which constitutes the core characteristic of BDD. The patient was successfully treated with imipramine.
Conclusion: The case suggests that certain features of TTM, RTM, and BDD may overlap and produce serious clinical consequences. Patients with this condition may benefit from a trial of tricyclics when other effective medications, such as serotonin reuptake inhibitors, are not available for use.