Dermotillomania-Excoriation Disorder
Excoriation disorder (also referred to as chronic skin-picking or dermatillomania) is a mental illness related to obsessive-compulsive disorder. It is characterized by repeated picking at one’s own skin which results in skin lesions and causes significant disruption in one’s life.
Clstr1:
Wik1: W060
Diagnoses: Dermotillimania (Excoriation Disorder)
USPatnts: Est. 4%
WrldPatnts:
SexRatio: M;F+
AveOnset: Can be permanent
Brain Area: anterior cingulate cortices-not inhibiting uncontrollable picking; inadequate SAPAP3 gene may also be a factor
Symptoms: picking sores into skin on the body; follows tension with relief following the act; mostly on the face by fingers or tools
Progression & Effects: causes scarring and disfigurement followed by shame and guilt; 11.5% attempt suicide; 79% pleasure with picking skin
Causes: childhood sexual abuse, rage against authoritarian parents, dealing with stress; affected by other itching conditions
Productive Medications: SSRI (antidepressants which increase serotonin and norepinephrine in the brain)antianxiety, antipsychotics; inositol
Productive Therapies: habit reversal training (for example, close a fist for one minute instead of picking when the urge arose)
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Youtube Video: Skin Picking Disorder (Dermatillomania)
Amazon or Library Book: Skin Picking-The Freedom to Finally Stop
Click the book to link or order from Amazon.
4 CURRENT ARTICLES
FROM PUBMED
The world-wide medical research
reports chosen for each diagnosis
Clicking each title opens the
PubMed article’s summary-abstract.
- Structured clinical interview for diagnosing obsessive-compulsive spectrum disordersby Christine Lochner on May 8, 2024
CONCLUSIONS: In OCD clinics, the SCID-OCSD may help diagnose the full range of putative OCSDs, and so facilitate treatment planning and research on these conditions.
- A Rare Case of Benign Recurrent Intrahepatic Cholestasis Initially Diagnosed in Middle-ageby Fang Liu on April 12, 2024
CONCLUSION: The comprehensive diagnosis of a middle-aged male patient with BRIC-2, which involved extensive radiological, hematological, and genetic investigations, informed a tailored tapering prednisone regimen, highlighting the importance of personalized medicine in managing atypical presentations of this rare cholestatic disorder.
- Low-Dose Naltrexone for Excoriation Disorderby Kevin Varghese on April 1, 2024
Excoriation (skin-picking) disorder (ED) is a condition characterized by the repeated compulsion to pick at the skin, causing physical trauma and psychiatric distress. Patients often desire to cease skin-picking behavior but are unable to do so. Multiple treatment modalities are effective for ED, including naltrexone. Previous reports of naltrexone for ED were at a high dose of 50 mg. The efficacy of low-dose naltrexone (LDN) at 4.5 mg in managing ED has not been reported. We present a case of a...
- A case report of an atypical severe case of skin picking disorder managed by a multidisciplinary teamby Marissa A LeBlanc on March 29, 2024
CONCLUSIONS: This case in particular highlighted the importance of urgent treatment via a multidisciplinary approach to avoid mortality. It highlights the importance of increasing awareness about the disorder and that treatment with SSRI's, along with antipsychotic and NAC adjuncts remains the mainstay of acute treatment.