Alopecia Totalis

Introduction SINCE the beginning of the century there has been a change in the pattern of suicide, associated with an increasing number of suicidal attempts. The more violent methods of self-destruction still occur, but there has been a marked rise in the proportion of attempts involving the less painful intoxications by coal-gas and drug overdo sage. Simpson (1961) has charted the increase during the past fifty years in the use of coalgas and such therapeutic drugs as the barbiturates and aspirin, at the expense of lysol and the corrosive poisons. In, a recent review of accidental and self-inflicted poisoning, Nicholson (1963) emphasized the pre-eminence of these two groups of drugs, but also described a variety of other therapeutic agents such as liniment, "asthma cure" and insulin which had been used in suicidal bids. This swing to drugs in normal medical use can be related to the increased number and availability of such preparations, together with the retention in most households of a stock of half-filled, unlabelled containers. Where such drugs are employed in an attention-seeking or gain-motivated suicidal gesture, ignorance of the actual preparation and its action may produce unexpected and dangerous consequences. The case here described provides an example of a suicidal bid in which an unusual, potentially lethal agent, colchicine, was used in ignorance of its effects, with the development of an uncommon clinical picture and the occurrence of an almost total alopecia.