Excoriation disorder: Difference between revisions

Jump to navigation Jump to search
Line 47: Line 47:
==Epidemiology and Demographics==
==Epidemiology and Demographics==
===Prevalence===
===Prevalence===
The prevalence of excoriation (Skin-Picking) disorder is 1,400 per 100,000 (1.4%) of the overall population.<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>
The prevalence of excoriation (skin-picking) disorder is 1,400 per 100,000 (1.4%) of the overall population.<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>


==Risk Factors==
==Risk Factors==

Revision as of 16:59, 13 November 2014

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]

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).

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.

Habits of excoriation disorder sufferers

Episodes of skin picking are often preceded or accompanied by tension, anxiety, stress, or paranoia. During these moments, there is commonly a compulsive urge to pick, bite, or scratch at a surface or region of the body, often at the location of a perceived skin defect. Sufferers may experience relief from upsetting emotions by engaging in skin picking.

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.

The regions most commonly affected by this are the face, back, scalp, stomach, chest, and extremities such as the hands, feet, and arms. Physical indicators of dermatillomania most commonly expressed in these areas are swelling, scarring, and callusing due to damage to the affected region's epidermis.

Aware of the damage they are inflicting, many sufferers feel and recognize a need to stop the behavior but are physically and mentally unable to do so without aid. Additionally, the behavior's addict-like characteristics are very similar to the expression of trichotillomania, or the compulsive pulling of hair from the body.

Many dermatillomania sufferers find that the disorder interferes with daily life. Plagued by shame, embarrassment, and humiliation, they may take measures to hide their disorder by not leaving the home, wearing long sleeves and pants in summer, or covering visible damage to skin with cosmetics and/or bandages. The disorder is typically found among females more than males.{

Causes

The inability to control the urge to pick is similar to trichotillomania.[1] Recent research suggests that, like trichotillomania, dermatillomania may be an impulse control disorder. This is part of the obsessive compulsive disorder spectrum.[2]

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.

Differential Diagnosis

  • 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 1,400 per 100,000 (1.4%) of the overall population.[3]

Risk Factors

Diagnostic Criteria

DSM-V Diagnostic Criteria for Excoriation (Skin-Picking) Disorder [3]

  • 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

Treatment

Few mental health practitioners have studied the disease, as many of these cases go unreported, but some individuals have found relief through cognitive-behavioral therapy. Hypnosis, self-hypnosis and meditation have also been useful for some patients. They are also sometimes prescribed medications, such as those prescribed for obsessive compulsive disorder. For example, artificial fingernails (acrylic or gel) have been found to be useful to some in stopping the picking behavior.

References

  1. http://www3.interscience.wiley.com/cgi-bin/abstract/90513484/ABSTRACT?CRETRY=1&SRETRY=0
  2. Brain Explorer - Focus on Brain Disorders - OCD - Related Spectrum Disorders
  3. 3.0 3.1 3.2 3.3 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.


Template:WikiDoc Sources