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Successful treatment of multiplex alopecia areata using transactional analysis: a case report.

Yamakita T, Shimizu Y, Arima M, Ashihara M, Matsunaga K - Case Rep Dermatol (2014)

Bottom Line: We therefore implemented a transactional analysis approach to increase the patient's score on the Free Child subscale.New hair growth was observed after 6 months and the bald patch disappeared after 2 years.Our results suggest that this method could also be easily applied in a clinical setting by dermatologists.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan.

ABSTRACT
The patient was a 13-year-old female. Six years previously, she developed alopecia areata when her parents divorced. One year after that, the bald area drastically expanded when her mother remarried. She was treated at her local hospital; however, no improvement was observed. She then visited our hospital for examination. A bald patch was covering >80% of her head. Self Grow-Up Egogram indicated the basic interpersonal relationship stance of 'I am not OK, You are OK'. We therefore implemented a transactional analysis approach to increase the patient's score on the Free Child subscale. New hair growth was observed after 6 months and the bald patch disappeared after 2 years. Our results suggest that this method could also be easily applied in a clinical setting by dermatologists.

No MeSH data available.


Related in: MedlinePlus

Results of SGE. The patient had the mindset ‘I am not OK, You are OK’ regarding interpersonal relationships. In this case, the NP subscale had the highest score and the FC subscale the lowest. CP = Critical Parent; NP = Nurturing Parent; A = Adult; FC = Free Child; AC = Adapted Child.
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Figure 2: Results of SGE. The patient had the mindset ‘I am not OK, You are OK’ regarding interpersonal relationships. In this case, the NP subscale had the highest score and the FC subscale the lowest. CP = Critical Parent; NP = Nurturing Parent; A = Adult; FC = Free Child; AC = Adapted Child.

Mentions: The patient was a 13-year-old girl with a history of nocturnal enuresis. Her parents divorced 6 years previously. Since then, circular bald patches appeared on her head; these patches exhibited repeated new growth and hair loss. She received treatment for this condition at her local hospital. Her mother remarried 1 year later. Since then, her hair loss became acutely exacerbated; therefore, she was examined at her local hospital once again. She underwent treatment with externally and internally administered corticosteroids in addition to liquid nitrogen therapy. This treatment did not completely cure her condition, and she was thus examined at our hospital. Bald patches of different sizes had merged to form one large reticular bald patch. The area of hair loss exceeded 80% of the patient's head (fig. 1). Her eyebrows and eyelashes were intact. Peripheral blood and biochemical tests revealed no aberrations, and autoantibodies and thyroid hormones were within the reference ranges. The results of psychological testing were as follows: Self-Rating Depression Scale 47 points, State-Trait Anxiety Inventory, state anxiety 48 points (high), and State-Trait Anxiety Inventory, trait anxiety 63 points (extremely high). Among the results of the Self Grow-Up Egogram (SGE), the score on the Nurturing Parent (NP) subscale was the highest and that on the Free Child (FC) subscale was the lowest (fig. 2). These data suggest the basic interpersonal relationship stance of ‘I am not OK, You are OK’. Unconditional positive affirmations, such as ‘you are important to us even if you lose your hair’, were repeatedly provided. In addition, we attempted to increase the FC ego state on SGE. In particular, when the patient underwent outpatient examinations, she was advised to speak about at least one interesting episode that had occurred in her daily life. Six months later, new hair growth was evident when she gained the ability to proactively talk about herself. Two years later, the bald patch had completely disappeared. There has been no recurrence of any bald patches during 5 years since her initial examination (fig. 3). While speaking about her feelings during her illness, she said, ‘When I was experiencing repeated hair loss, I couldn't forgive myself for losing my hair. Thinking about it now, I feel that I was blaming myself excessively.’


Successful treatment of multiplex alopecia areata using transactional analysis: a case report.

Yamakita T, Shimizu Y, Arima M, Ashihara M, Matsunaga K - Case Rep Dermatol (2014)

Results of SGE. The patient had the mindset ‘I am not OK, You are OK’ regarding interpersonal relationships. In this case, the NP subscale had the highest score and the FC subscale the lowest. CP = Critical Parent; NP = Nurturing Parent; A = Adult; FC = Free Child; AC = Adapted Child.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4255999&req=5

Figure 2: Results of SGE. The patient had the mindset ‘I am not OK, You are OK’ regarding interpersonal relationships. In this case, the NP subscale had the highest score and the FC subscale the lowest. CP = Critical Parent; NP = Nurturing Parent; A = Adult; FC = Free Child; AC = Adapted Child.
Mentions: The patient was a 13-year-old girl with a history of nocturnal enuresis. Her parents divorced 6 years previously. Since then, circular bald patches appeared on her head; these patches exhibited repeated new growth and hair loss. She received treatment for this condition at her local hospital. Her mother remarried 1 year later. Since then, her hair loss became acutely exacerbated; therefore, she was examined at her local hospital once again. She underwent treatment with externally and internally administered corticosteroids in addition to liquid nitrogen therapy. This treatment did not completely cure her condition, and she was thus examined at our hospital. Bald patches of different sizes had merged to form one large reticular bald patch. The area of hair loss exceeded 80% of the patient's head (fig. 1). Her eyebrows and eyelashes were intact. Peripheral blood and biochemical tests revealed no aberrations, and autoantibodies and thyroid hormones were within the reference ranges. The results of psychological testing were as follows: Self-Rating Depression Scale 47 points, State-Trait Anxiety Inventory, state anxiety 48 points (high), and State-Trait Anxiety Inventory, trait anxiety 63 points (extremely high). Among the results of the Self Grow-Up Egogram (SGE), the score on the Nurturing Parent (NP) subscale was the highest and that on the Free Child (FC) subscale was the lowest (fig. 2). These data suggest the basic interpersonal relationship stance of ‘I am not OK, You are OK’. Unconditional positive affirmations, such as ‘you are important to us even if you lose your hair’, were repeatedly provided. In addition, we attempted to increase the FC ego state on SGE. In particular, when the patient underwent outpatient examinations, she was advised to speak about at least one interesting episode that had occurred in her daily life. Six months later, new hair growth was evident when she gained the ability to proactively talk about herself. Two years later, the bald patch had completely disappeared. There has been no recurrence of any bald patches during 5 years since her initial examination (fig. 3). While speaking about her feelings during her illness, she said, ‘When I was experiencing repeated hair loss, I couldn't forgive myself for losing my hair. Thinking about it now, I feel that I was blaming myself excessively.’

Bottom Line: We therefore implemented a transactional analysis approach to increase the patient's score on the Free Child subscale.New hair growth was observed after 6 months and the bald patch disappeared after 2 years.Our results suggest that this method could also be easily applied in a clinical setting by dermatologists.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan.

ABSTRACT
The patient was a 13-year-old female. Six years previously, she developed alopecia areata when her parents divorced. One year after that, the bald area drastically expanded when her mother remarried. She was treated at her local hospital; however, no improvement was observed. She then visited our hospital for examination. A bald patch was covering >80% of her head. Self Grow-Up Egogram indicated the basic interpersonal relationship stance of 'I am not OK, You are OK'. We therefore implemented a transactional analysis approach to increase the patient's score on the Free Child subscale. New hair growth was observed after 6 months and the bald patch disappeared after 2 years. Our results suggest that this method could also be easily applied in a clinical setting by dermatologists.

No MeSH data available.


Related in: MedlinePlus