|Year : 1994 | Volume
| Issue : 2 | Page : 101-102
Pimozide treatment of Plica neuropathica
Rakesh Bharti, HP Singh
Source of Support: None, Conflict of Interest: None
Irrespective of the cause, treatment of plica neuropathica remains cutting of tangled hairs at the outset, and avoiding the cause in future so as to stop recurrences. Successful management of plica in a psychologically disturbed widow with 2 mg. daily Pimozide - a drug for acute and chronic schizophrenias and manic excitement patients, is reported.
Keywords: Plica neuropathica, Pimozide
|How to cite this article:|
Bharti R, Singh H P. Pimozide treatment of Plica neuropathica. Indian J Dermatol Venereol Leprol 1994;60:101-2
| Introduction|| |
Plica neuropathica cases have been reported by different workers from time to time due to rapid manipulation of hairs after application of detergent shampoos, setting lotions, bleaching and waving solutions ,,,, and psychological factors have also been reported to exist in some cases.  We are reporting the case of a widow having plica neuropathica since her widowhood, probably due to psychological reasons, cured by pimozide, a drug for acute and chronic schizophrenias and manic excitement.
| Case Report|| |
A 40-year-old housewife reported with matting of hairs for 9 years since her widowhood. She appeared to be overactive and told that she used to forget, even she could not recollect the date of her husband's death exactly. There was no history of use of any detergent shampoo, bleach, dyes, setting lotions or soap for her hairs since her widowhood. She used to apply mustard oil to her hairs since her childhood. The patient was non diabetic, non hypertensive and denied history of systemic medication. On physical examination scalp hairs were grey and black, dry, kinky, irregularly twisted and irreversibly entangled at distal ends (5-12 cms) producing compact masses of 20-30 hairs each and proximal ends were not involved. The hairs otherwise were normal in texture, free of any malodor or parasites. Frontal section of hairs were short and grey in between and there was no alopecia. Light microscopic examination showed normal follicles and shaft structure without any evidence of dermatophytes. Samples of uninvolved hairs when rubbed between fingers for a minute became partially tangled. Psychiatric assessment revealed that she was a hysterical woman with depression and an element of obscessive compulsive neurosis. She was advised to cut the involved hairs and was put on Alprozolam, Pimozide, Iron, B-Complex and protein supplement. She was free of any recurrence of plica even 3 months, whereas earlier she used to have recurrence every fortnight.
The patient is still under treatment and had no arrythemias or prolongation of Q-T interval in 3 months time.
The mainstay of treatment of plica neuropathica, caused either by detergent shampoo, bleaches, waving solutions etc. or psychological disturbances, remains cutting of tangled hairs at the outset and avoiding the cause in future. Whereas recurrence in first set of patients is stoppable by avoiding the use of offending agents, the recurrences in psychologically disturbed persons can best be curtailed by psychiatric management. Visiting a psychiatrist, however, remains a stigma still, in our country and a patient prefers to be treated by his/her family physician or the dermatologist he or she visits for plica rather than going to a psychiatrist.
Sudden onset of plica, healthy scalp free of offensive odour and parasites and marked improvement of the condition with psychiatric treatment with Pimozide, in the case reported makes it an interesting and worth reporting.
| References|| |
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