The article is devoted to a psychodermatological disorder with self-destructive behavior - hypochondriasis circumscripta. Presented data are based on a clinical analysis of 22 consecutive cases (15 female; mean age - 56.1 ± 12.6 years) observed in the dermatologic department of First Moscow State Medical University and managed in a multidisciplinary approach by dermatologists and a consultation-liaison psychiatrist. Psychopathology, clinical presentations, historical aspects and treatment options are discussed. The self-inflicted skin lesions result from a severe repetitive autodestruction of focal skin loci primarily affected with heterogeneous sensations associated with a hypochondrical over-valued idea. Hypochondriasis сircumscripta is a serious diagnostic and treatment challenge and should be distinguished from dermatitis artefacta, skin picking disorder and delusional infestation.