P.N. SURESH KUMAR et al. with faith in the salutary influence of a plica. Despite the role of psychological disturbance in this condition as a risk factor there is nqt even a single case report of plica polonica in psychiatric journals While reviewing the Indian literature on this subject, few cases, could be searched out published in various dermatology journals (Hajini etal, 1982; Mam and Sahni, 1S83; Khare, 1685; Sharmaetal, 1987 and Pavithran. 1990) Herein, a 30-year-old female patient who developed plica neuropathica after one year of continuous mental illness is described. CASE REPORT Mrs A was a 30- year-old, married, Hindu female presented with two years history of continuous illness characterised by delusion of persecution, muttering to self, social withdrawal and preoccupied behavior During the course of illness, around one year back, she developed sudden tangling of hair. After this, she has not opened the hair lock which was tied up earlier or not combed the hair. However, she was oiling and washing the hair regularly Few weeks after the onset of tangling of hair, it was infested with lice, but there was no secondary scalp infection or malodour Even with repeated probing, patient was refused answer the reason for thi6 particular behaviour Her parents revealed that she has been told to her parents that the hair can be cut only In a religious set up after getting her consent. Her physical examination was within normal limits Routine blood investigations and biochemical parameters did not reveal any abnormality She was admitted in hospital for detailed evaluation and was diagnosed to have schizophrenia-undifferentiated type as per DSM- IV criteria Because of her odd hair condition dermatology consultation was sought and was diagnosed as plica polonica She was treated with a daily dose of risperidone 8 milligram per day and trihexyphenidyl 4 milligrams per day. During the period of inpatient stay of three weeks she showed significant improvement in the psychopathology except the odd hairstyle. Even after rigorous psychopharmacological treatment and psychosocial Intervention, patient as well the family members refused to comply with the therapist's instruction to cut the hair. After three weeks patient was discharged at request of her parents and lost foi> follow up. DISCUSSION Plica neuropathica has been reported very rarely though it is seen more frequently Along with other risk factors as mentioned in literature, psychological disturbance is a predisposing factor for this condition in some patients. In this case, the patient had a continuous illness of two years duration and her personal care was well maintained except the hair care She developed plica neuropathica all of on a sudden, one year after the onset of illness. There were no predisposing factors like kinky hair, febrile illness, change in toilet soap or shampoo or mechanical effects like rubbing together of hair. Moreover, she hada delusion with religious colouring that removal of hair would be harmful to her as well as family members and hence wanted to preserve he matted hair. Hence it was inferred that the predisposing and perpetuating factors for plica polonica in this patient was her mental illness. The authors would be interested to hear similar case reports from other clinicians. REFERENCES Agnes,S.(1952) The Hair and Scalp, ed 4, London; Edward Arnold and,Company,244. De Amis (1923) Cited by Stelwagon and Gaskeill: Diseases of the Skin," 9th edition, Philadelphia; Saunders Company, 1018-1020. Dubreuilh (1923) Cited by Jackson, G.T. andMcMurthy, C W ; A Treatise on Diseases of the Hair, Philadelphia, Lea & Febiger Publishers, 186. Freidli, A., Peerriard-Wolfensberger, J.& Harms.M. (2000) Plica polonica in the 21st century. Hautarzt, 51 (3), 201-202. 282