Disease that starts with a well-defined patch on the skin that causes itching and scratching. As a result, the affected skin becomes rough and thickened (lichenification). It is not a contagious disease. Women, mainly from 30 to 50 years old, are more likely to suffer from it.
Its cause is unknown. It may be related to chronic skin diseases such as dry skin, eczema or psoriasis. Stress and anxiety can also aggravate its itchiness.
It is presented as a single or several patches on the skin that cause a very intense itching. It usually involves the back of the neck, forearms, legs, scrotum and vulva. The itching may be so intense or recurrent it affects sleep, sexual function and quality of life.
Diagnosis is based on a clinical questioning and a physical examination. A skin biopsy may be needed to rule out other diseases.
The goal of the treatment is to control the itching sensation, prevent scratching and avoid other triggering diseases. Cortisone and antihistamine creams help soothe the itchiness. Anxiolytics can be prescribed in order to improve the nervousness associated with the constant itching.
It needs to be taken into consideration that continued scratching can cause wounds, a bacterial infection or persistent scars on the skin.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington 2013.
- Keuthen NJ, Koran LM, Aboujaoude E, et al. The prevalence of pathologic skin picking in US adults. Compr Psychiatry 2010; 51:183.
- Hayes SL, Storch EA, Berlanga L. Skin picking behaviors: An examination of the prevalence and severity in a community sample. J Anxiety Disord 2009; 23:314.
- Machado MO, Köhler CA, Stubbs B, et al. Skin picking disorder: prevalence, correlates, and associations with quality of life in a large sample. CNS Spectr 2018; 23:311.
- Bohne A, Wilhelm S, Keuthen NJ, et al. Skin picking in German students. Prevalence, phenomenology, and associated characteristics. Behav Modif 2002; 26:320.
- Odlaug BL, Lust K, Schreiber LR, et al. Skin picking disorder in university students: health correlates and gender differences. Gen Hosp Psychiatry 2013; 35:168.
- Houghton DC, Alexander JR, Bauer CC, Woods DW. Body-focused repetitive behaviors: More prevalent than once thought? Psychiatry Res 2018; 270:389.
- Odlaug BL, Grant JE. Clinical characteristics and medical complications of pathologic skin picking. Gen Hosp Psychiatry 2008; 30:61.
- Ricketts EJ, Snorrason Í, Kircanski K, et al. A latent profile analysis of age of onset in pathological skin picking. Compr Psychiatry 2018; 87:46.
- Odlaug BL, Grant JE. Childhood-onset pathologic skin picking: clinical characteristics and psychiatric comorbidity. Compr Psychiatry 2007; 48:388.
- Odlaug BL, Hampshire A, Chamberlain SR, Grant JE. Abnormal brain activation in excoriation (skin-picking) disorder: evidence from an executive planning fMRI study. Br J Psychiatry 2016; 208:168.
- Wabnegger A, Schienle A. The Role of the Cerebellum in Skin-Picking Disorder. Cerebellum 2019; 18:91.
- Schienle A, Übel S, Wabnegger A. Visual symptom provocation in skin picking disorder: an fMRI study. Brain Imaging Behav 2018; 12:1504.
- Blum AW, Chamberlain SR, Harries MD, et al. Neuroanatomical Correlates of Impulsive Action in Excoriation (Skin-Picking) Disorder. J Neuropsychiatry Clin Neurosci 2018; 30:236.
- Neziroglu F, Rabinowitz D, Breytman A, Jacofsky M. Skin picking phenomenology and severity comparison. Prim Care Companion J Clin Psychiatry 2008; 10:306.
