Excoriation disorder

Jump to navigation Jump to search

WikiDoc Resources for Excoriation disorder

Articles

Most recent articles on Excoriation disorder

Most cited articles on Excoriation disorder

Review articles on Excoriation disorder

Articles on Excoriation disorder in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Excoriation disorder

Images of Excoriation disorder

Photos of Excoriation disorder

Podcasts & MP3s on Excoriation disorder

Videos on Excoriation disorder

Evidence Based Medicine

Cochrane Collaboration on Excoriation disorder

Bandolier on Excoriation disorder

TRIP on Excoriation disorder

Clinical Trials

Ongoing Trials on Excoriation disorder at Clinical Trials.gov

Trial results on Excoriation disorder

Clinical Trials on Excoriation disorder at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Excoriation disorder

NICE Guidance on Excoriation disorder

NHS PRODIGY Guidance

FDA on Excoriation disorder

CDC on Excoriation disorder

Books

Books on Excoriation disorder

News

Excoriation disorder in the news

Be alerted to news on Excoriation disorder

News trends on Excoriation disorder

Commentary

Blogs on Excoriation disorder

Definitions

Definitions of Excoriation disorder

Patient Resources / Community

Patient resources on Excoriation disorder

Discussion groups on Excoriation disorder

Patient Handouts on Excoriation disorder

Directions to Hospitals Treating Excoriation disorder

Risk calculators and risk factors for Excoriation disorder

Healthcare Provider Resources

Symptoms of Excoriation disorder

Causes & Risk Factors for Excoriation disorder

Diagnostic studies for Excoriation disorder

Treatment of Excoriation disorder

Continuing Medical Education (CME)

CME Programs on Excoriation disorder

International

Excoriation disorder en Espanol

Excoriation disorder en Francais

Business

Excoriation disorder in the Marketplace

Patents on Excoriation disorder

Experimental / Informatics

List of terms related to Excoriation disorder

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2] Yashasvi Aryaputra[3]

Synonyms and keywords: Compulsive skin picking; CSP; dermatillomania; neurotic excoriation; psychogenic excoriation

Overview

Excoriation disorder (also known as dermatillomania, compulsive skin picking, neurotic excoriation, psychogenic excoriation, or CSP) is an impulse control disorder and form of self-injury characterized by the repeated urge to pick at one's own skin, often to the extent that damage is caused. Excoriation disorder may be related to body dysmorphic disorder (BDD).[1]

Compulsive picking of the knuckles (via mouth) illustrating disfiguration of the distal and proximal joints of the middle and little fingers.

Sufferers of dermatillomania find skin picking to be stress relieving or gratifying, though it can still be as physically painful as it would be for a non-skin picker.

Historical Perspective

  • Lous-Anne-Jean Brocq was the first person to mention excoriation disorder on paper. She used the term in 1898 to describe a patient who uncontrollably picked their acne.

Classification

  • In some animal models, it has been shown that animals that who excessively pull their hairs have more endorphin receptors in their brain than animals who do not. Endorphin receptors enable endorphins to have an effect on the brain. If this is true for humans, people who are particularly compulsive about their repetitive habits may have more endorphin receptors in their brain as well. This may explain why sufferers get more enjoyment out of picking their scabs than others.

Pathophysiology

  • Those suffering from excoriation disorder have very damaged skin, as a result of picking at it constantly.
Skin Picking results on arms, shoulders and chest are visible. While this look can be a social disturbance, it is also a time-consuming habit.

Differential Diagnosis

Excoriation disorder must be differentiated from:

  • Neurodevelopmental disorders
  • Other disorders
  • Other medical conditions
  • Somatic symptom and related disorders
  • Substance/medication-induced disorders

Epidemiology and Demographics

Prevalence

  • The prevalence of excoriation (skin-picking) disorder is approximately 1,400 per 100,000 (1.4%) individuals worldwide.[6]
  • About 2% of dermatology patients suffer from excoriation disorder.[3]

Age

  • The age of onset for excoriation disorder is likely either under 10 years old or between 30 and 45 years old.[3]

Risk Factors

Common risk factors in the development of excoriation disorder include:

Natural History, complications, and prognosis

Natural History

  • The symptoms of excoriation disorder usually develop either under 10 years of age or between 30 and 45 years old.[3]

Complications

  • There are no known complications associated with excoriation disorder.

Prognosis

  • Those who suffer from this disorder tend to wear long sleeved clothing, even in warm weather, to hide any damaged skin. They are hindered by embarrassment when going out in public. If excoriation disorder is left untreated, it can last as long as 21 years.

Diagnostic Criteria

DSM-V Diagnostic Criteria for Excoriation (Skin-Picking) Disorder [6]

  • A. Recurrent skin picking resulting in skin lesions.

AND

  • B. Repeated attempts to decrease or stop skin picking.

AND

  • C. The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

AND

  • D. The skin picking is not attributable to the physiological effects of a substance (e.g.,cocaine) or another medical condition (e.g., scabies).

AND

History and Symptoms

  • History of picking at the the skin
  • History of personal issues such as abuse that may lead to these behaviors.
  • Acne already preexisting on the body.

Laboratory Findings

  • There are no diagnostic laboratory findings associated with excoriation disorder.

Other Imaging Studies

  • There are no other imaging findings associated with excoriation disorder.

Other Diagnostic Studies

There are no other diagnostic studies associated with excoriation disorder.

Medical Therapy

Psychotherapy

  • These strategies help reduce skin picking behavior in individuals with excoriation disorder, but no psychological issues.[3][7][8]

Brain Stimulation Therapy

  • There is no brain stimulation therapy associated with excoriation disorder.

Cost Effectiveness of Therapy

Future or Investigational Therapies

References

  1. Deckersbach T, Wilhelm S, Keuthen NJ, Baer L, Jenike MA (2002). "Cognitive-behavior therapy for self-injurious skin picking. A case series". Behav Modif. 26 (3): 361–77. doi:10.1177/0145445502026003004. PMID 12080906.
  2. Black, Donald (2014). DSM-5 guidebook : the essential companion to the Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Publishing. ISBN 978-1585624652.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 Odlaug BL, Grant JE (2010). "Pathologic skin picking". Am J Drug Alcohol Abuse. 36 (5): 296–303. doi:10.3109/00952991003747543. PMID 20575652.
  4. http://www3.interscience.wiley.com/cgi-bin/abstract/90513484/ABSTRACT?CRETRY=1&SRETRY=0
  5. Brain Explorer - Focus on Brain Disorders - OCD - Related Spectrum Disorders
  6. 6.0 6.1 6.2 6.3 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
  7. Dell'Osso B, Altamura AC, Allen A, Marazziti D, Hollander E (2006). "Epidemiologic and clinical updates on impulse control disorders: a critical review". Eur Arch Psychiatry Clin Neurosci. 256 (8): 464–75. doi:10.1007/s00406-006-0668-0. PMC 1705499. PMID 16960655.
  8. Lang R, Didden R, Machalicek W, Rispoli M, Sigafoos J, Lancioni G; et al. (2010). "Behavioral treatment of chronic skin-picking in individuals with developmental disabilities: a systematic review". Res Dev Disabil. 31 (2): 304–15. doi:10.1016/j.ridd.2009.10.017. PMID 19963341.


Template:WikiDoc Sources