Psychodermatology of skin picking (excoriation disorder): A comprehensive review

Dermatol Ther. 2020 Jul;33(4):e13661. doi: 10.1111/dth.13661. Epub 2020 Jun 16.

Abstract

Excoriation disorder (ED) is a primary psychiatric disorder characterized by recurrent skin picking, which may lead to self-induced cutaneous lesions and significant distress or functional impairment. The affected patient is aware of his/her self-destructive behavior but feels unable to give up this habit, despite having made repeated attempts to decrease or stop it. ED is a relatively frequent disorder, of notable heterogeneity and phenomenological complexity, accompanied by significant emotional and physical consequences. Therefore, further research is necessary to enhance the knowledge on its clinical manifestations, epidemiology, and comorbidities. This article presents an update regarding the etiopathogenesis, clinical aspects, and treatment options of ED to provide an up-to-date review for psychiatrists, dermatologists, and general practitioners.

Keywords: excoriation disorder; primary psychiatric disorder; psychodermatology; skin picking.

Publication types

  • Review

MeSH terms

  • Comorbidity
  • Female
  • Humans
  • Male
  • Mental Disorders* / diagnosis
  • Mental Disorders* / epidemiology
  • Mental Disorders* / therapy
  • Self-Injurious Behavior* / diagnosis
  • Self-Injurious Behavior* / epidemiology
  • Self-Injurious Behavior* / therapy
  • Skin
  • Skin Diseases* / diagnosis
  • Skin Diseases* / epidemiology
  • Skin Diseases* / therapy