| H01449 | |
| H number | H01449 |
| Name | Excoriation disorder; Skin picking disorder |
| Description | Excoriation Disorder, also known as Skin Picking Disorder, is characterized by the repetitive and compulsive scratching or picking of skin, which causes tissue damage. Patients spend a significant amount of time each day picking their skin, that causes psychosocial impairment. Triggers to pick vary greatly. For example, stress, anxiety, boredom, and feeling tired or angry have all been reported as triggers. Co-occurring psychiatric conditions are common in this disease. The most commonly reported comorbid conditions are trichotillomania, substance dependence, major depressive disorder, anxiety disorders, obsessive compulsive disorder (OCD), and body dysmorphic disorder (BDD). So far, there is no clear neurobiological explanation for the etiology of this disease. Recent research showed bilateral abnormalities in the anterior cingulate cortex and abnormalities on the left temporoparietal junction. Another study has shown deficits in motor inhibition, which appears to be correlated with frontal cortex abnormalities. Furthermore, severity of excoriation disorder may be associated with higher levels of impulsivity. Treatment for this disease has largely focused on cognitive behavioral therapy and pharmacology. Early psychosocial treatment studies provided evidence for skin picking reduction with habit reversal or acceptance-enhanced behavior therapy (AEBT). The data for selective serotonin reuptake inhibitors (SSRIs) efficacy in this disease are not convincing, although some studies suggested that fluoxetine is effective. Tricyclic antidepressants, neuroleptics, and the dopamine-blocking opioid antagonist have also been found to be effective for skin-picking. |
| Category | Mental and behavioural disorder |
| Network | - |
| Gene | - |
| Pathogen | - |
| Env factor | - |
| Carcinogen | - |
| Drug | - |
| Comment | In the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), excoriation disorder has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD) category. |
| Other DBs | ICD-11: 6B25.1 ICD-10: F48.9 |
| Reference | PMID:25591046 AUTHORS Oliveira EC, Leppink EW, Derbyshire KL, Grant JE TITLE Excoriation disorder: impulsivity and its clinical associations. JOURNAL J Anxiety Disord 30:19-22 (2015) DOI:10.1016/j.janxdis.2014.12.010 PMID:23128921 AUTHORS Grant JE, Odlaug BL, Chamberlain SR, Keuthen NJ, Lochner C, Stein DJ TITLE Skin picking disorder. JOURNAL Am J Psychiatry 169:1143-9 (2012) DOI:10.1176/appi.ajp.2012.12040508 PMID:20575652 AUTHORS Odlaug BL, Grant JE TITLE Pathologic skin picking. JOURNAL Am J Drug Alcohol Abuse 36:296-303 (2010) DOI:10.3109/00952991003747543 PMID:18334614 (treatment) AUTHORS Flessner CA, Busch AM, Heideman PW, Woods DW TITLE Acceptance-enhanced behavior therapy (AEBT) for trichotillomania and chronic skin picking: exploring the effects of component sequencing. JOURNAL Behav Modif 32:579-94 (2008) DOI:10.1177/0145445507313800 PMID:20694122 (Drug) AUTHORS Jafferany M, Shireen F, Ibrahim A TITLE An open-label trial of topiramate in the treatment of skin picking in pervasive developmental disorder not otherwise specified. JOURNAL Prim Care Companion J Clin Psychiatry 12:PCC.09l00829 (2010) DOI:10.4088/PCC.09l00829yel |