Materiały źródłowe

• #1 Prevalence of skin picking (excoriation) disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7115927/

  Skin picking (excoriation) disorder is a mental health condition characterized by repetitive picking of one’s skin leading to tissue damage as well as functional impairment and/or distress. A convenience sampling of 10,169 adults, aged 1869 years, representative of the general US population, completed a survey to establish occurrence of skin picking disorder. 213 participants (2.1%) (55.4% female) identified as having current skin picking disorder and 318 (3.1%) (54.1% female) reported lifetime skin picking disorder (i.e. current or past). This study suggests that skin picking disorder is relatively common in the general population and typically characterized by high rates of comorbidity. […] To date, no nationwide epidemiological studies of skin picking disorder have been conducted, but there have been several smaller studies of the prevalence of skin picking disorder. A far smaller number of studies have been conducted in the community. In one study of 354 people randomly selected in public places, 63% of respondents engaged in some form of picking, but only 19 respondents (5.4%) reported significant picking with associated distress or impact. Another study, based on 2,513 telephone interviews, found that 10% of respondents picked to the point of having noticeable skin damage that was not attributable to a medical condition. Finally, in a study in Brazil, 7639 participants were recruited using a web-based survey and a 12-item self-report form on skin picking. This study found that 3.4% endorsed current probable skin picking disorder.

• #2 Prevalence and gender distribution of excoriation (skin-picking) disorder: A systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/37023597/

  Epidemiological studies of excoriation disorder have reported different prevalence estimates for this condition, limiting our understanding of its public health impact. […] We aimed to estimate the pooled prevalence and the female-to-male ratio of excoriation disorder in the general population. […] Meta-analyses demonstrated that excoriation disorder has an overall prevalence of 3.45% (95% CI 2.55, 4.65%) and impacts women more than men (female-to-male OR = 1.45; 95% CI 1.15, 1.81, p = 0.001). […] These findings underscore the public health impact of excoriation disorder, which will hopefully motivate future research focused on advancing our understanding and management of this condition.

• #3 Epidemiology and Comorbidities of Excoriation Disorder: A Retrospective Case-Control Study

  https://www.mdpi.com/2077-0383/9/9/2703

  Excoriation disorder is a psychocutaneous disorder characterized by repetitive skin-picking and associated with significant morbidity. Currently, epidemiological data in patients with excoriation disorder are lacking so we sought to characterize common patient demographics and comorbidities. […] ED has an estimated prevalence of 1.4–5.4% in the United States and is often associated with increased rates of psychiatric comorbidity. […] To date, few studies address the epidemiology, health comorbidities, and clinical outcomes of patients with ED, posing challenges to the diagnosis and treatment of ED. […] Compared to matched controls, ED patients in this study were more likely to have type 2 diabetes and hepatitis C, two conditions which have previously been reported to be associated with chronic pruritus.

• #4 Excoriation Disorder: Practice Essentials, Background, Pathophysiology and Etiology

  https://emedicine.medscape.com/article/1122042-overview

  A meta-analysis of 19 studies with 38,038 participants revealed that excoriation disorder has a pooled prevalence of 3.45%. The analysis also showed that excoriation disorder is more prevalent in women than men, with a female-to-male odds ratio of 1.45. […] The rate of neurotic excoriations among patients at dermatologic clinics is 2%, while the rate in patients with pruritus is 9%. […] Most studies indicate the mean age at onset is between 30-45 years, though it often begins during adolescence. […] Excoriation (skin-picking) disorder is more commonly found in individuals with first-degree relatives who have the disorder or in those with obsessive-compulsive disorder. Studies have found that trichotillomania and excoriation disorder co-occur more often than expected, sharing substantial similarities in clinical characteristics and overlapping risk factors.

• #5 Prevalence of skin picking (excoriation) disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7115927/

  The study sample comprised 10,169 adults. In total, 213 participants in the sample (2.1%) identified as having current skin picking disorder. Lifetime skin picking disorder (i.e. current or past) was reported by 318 participants (3.1%). The rates of current comorbidities reported in people with skin picking disorder were as follows (listed in order of decreasing frequency): generalized anxiety disorder (135 [63.4%]), depression (n = 133 [53.1%]), panic disorder (59 [27.7%]), post-traumatic stress disorder (PTSD) (58 [27.2%]), obsessive-compulsive disorder (OCD) (56 [26.3%]), attention-deficit hyperactivity disorder (ADHD) (50 [23.5%]), eating disorder (41 [19.3%]), drug or alcohol abuse (34 [16.0%]), trichotillomania (27 [12.7%]), bipolar disorder (26 [12.2%]), and tic disorder (15 [7.0%]).

• #6 Excoriation (Skin Picking) Disorder Statistics and Prevalence

  https://www.therecoveryvillage.com/mental-health/excoriation/excoriation-statistics/

  Excoriation statistics reveal the prevalence of this condition, as well as which other mental health disorders it commonly co-occurs with. […] Excoriation disorder prevalence may be more common than one would assume: An estimated 25% of the population has excoriation disorder. […] Excoriation is most common among kids between the ages of 13-15 years old but can also affect younger children and adults ages 30-45. […] Dermatillomania can be present in males and females, but it is more common in females. […] While excoriation disorder often exists on its own, it may also co-occur with OCD or hair pulling, trichotillomania. The co-occurrence of excoriation and trichotillomania is 38%. […] Excoriation disorder can be managed and successfully treated.

• #7 Excoriation Disorder | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618322/all/Excoriation_Disorder?q=Pruritus

  Excoriation or skin picking disorder (ExD) is recurrent picking at ones skin to the point of causing skin lesions or recurrent bleeding. […] Although ExD can occur in children 10 years and in adults, the typical onset is in adolescence between ages 13 and 15 years. […] 75% or more of individuals with ExD are female.

• #8 Excoriation Disorder (Skin Picking or Dermatillomania) | Mental Health America

  https://mhanational.org/conditions/excoriation-disorder-skin-picking-or-dermatillomania/

  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 areas of swollen or broken skin and causes significant disruption in one’s life. […] Skin picking is a body-focused repetitive behavior (BFRB) that typically begins during adolescence, often with, or after the onset of, puberty around ages 13-15, but may also occur among children or adults. The condition affects between 1.4 and 5.4% of American adults and is experienced by women more often than men. […] This disorder is usually chronic, with periods of time where there is no picking alternating with periods of greater symptom intensity. If untreated, skin-picking behaviors may come and go for weeks, months, or years at a time.

• #9 Skin picking disorder | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/12/clinical-review/skin-picking-disorder

  Skin picking disorder is an under-recognised mental disorder that typically starts during adolescence and leads to considerable emotional distress and/or reduced functioning in important areas of life. […] In terms of incidence, few people come forward for treatment, which may be related to shame or trivialisation. […] The point prevalence is reported to be between 1.9-2.1 % and lifetime prevalence between 3.1-5.4 %. […] More women than men seek treatment, but screening studies suggest a less pronounced difference between the sexes with approximately 55 % women. […] Comorbidities are common, particularly generalised anxiety disorder and depression. […] Sick leave and problems in work, school and social situations are common. […] The disorder is associated with shame and avoidance behaviour.

• #10 Dermatillomania (Skin Picking) | Psychology Today

  https://www.psychologytoday.com/us/conditions/dermatillomania-skin-picking

  Excoriation disorder is relatively rare but is thought to affect up to 1.4 percent of the total population. Approximately 75 percent of those diagnosed with the disorder are female. […] Experts believe that gender differences in diagnosis rates are largely reflective of the disorders true incidence in men vs. women. However, an increased emphasis on womens physical appearance in many cultures may compel more women to seek treatment for the condition, thus skewing diagnosis rates slightly.

• #11 Dermatillomania (Skin Picking): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22706-dermatillomania-skin-picking

  Dermatillomania is an uncommon condition, with an estimated 2% of people having it at any time and up to 5.4% of people having this condition at some point in their life. […] In years past, experts believed this condition was much more common in women. However, recent research shows that only about 55% of people with this condition are women. Women are also more likely to seek treatment for this problem. […] Dermatillomania usually isnt a dangerous condition unless it’s very severe. The main risk from this condition is from open wounds, which might develop infections because of repeated picking or damage. Though this condition isnt usually dangerous directly, it still commonly has severe negative effects on your quality of life and overall sense of well-being.

• #12

  https://link.springer.com/article/10.1007/s12144-023-05377-4

  Skin picking disorder (SPD) is a body-focused repetitive behavior recently added to the DSM-V. It mainly affects women, with a prevalence ranging from 1.5 to 5.4%. […] The prevalence of the disorder ranges from 1.5 to 5.4%, but several authors argue that it is underestimated because some patients do not recognize the pathological nature of their picking behavior. SPD appears to affect more women than men, and there are three critical ages of onset: childhood (10 years), adolescence or late adolescence (15-21 years), and between 30 and 45 years. After onset, the disorder tends to follow a chronic course, with periods of ups and downs; the average duration of the disorder is around 20 years. […] Research on the effectiveness of medical treatments is limited. The preferred psychotherapeutic treatment is cognitive behavioral, which attempts to reduce or eliminate the habitual behaviors causing distress. However, some studies suggest that professionals’ knowledge of the disorder is limited, leading to difficulty in obtaining appropriate diagnosis or treatment.

• #12

  https://link.springer.com/article/10.1007/s12144-023-05377-4

  Studies show a significant impact of the disorder at an individual and interpersonal level. SPD has a negative influence on quality of life and is associated with psychological distress, particularly anxiety, stress, tension, and depression, and problematic management of emotions, which can be elicited or diminished by picking behavior, thus acting as positive/negative reinforcement. The disorder causes shame and social embarrassment, leading to avoidance behavior and social withdrawal. […] Overall, researchers are still debating this newly identified disorder, highlighting the need for further investigation in light of the heterogeneous picture of symptomatology and the limited overall research on SPD.

• #13 Excoriation (Skin-Picking) Disorder | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/excoriation-skin-picking-disorder/

  In some patients, excoriation disorder begins with the onset of acne in adolescence, but the compulsion continues even after the acne has gone away. […] Certain stressful events including marital conflicts, deaths of friends or family, and unwanted pregnancies have been linked to the onset of the condition. […] If excoriation disorder does not occur during adolescence, another common age of onset is between the ages of 30 to 45. […] Additionally, many cases of excoriation disorder have been documented to begin in children under the age of 10. […] One small survey of patients with excoriation disorder found that 47.5% of them had an early onset of excoriation disorder that began before age 10. […] Traumatic childhood events may initiate the behavior.

• #14 Excoriation Disorder (aka Skin Picking, Dermatillomania): Information for Healthcare Providers : Halton Regional Municipality, ON : eMentalHealth.ca

  https://primarycare.ementalhealth.ca/Ottawa-Carleton/Excoriation-Disorder-aka-Skin-Picking-Disorder/index.php?m=article&ID=52634&r=halton

  Likely common and under-reported (Cyr, 2001). […] Age of onset: Age 15-45 (Park, 2016). […] Primarily affects females (APA, 2013). […] Incidence among patients in dermatology clinics is 2% (Cyr, 2001). […] Prevalence among patients with pruritis is 9% (Cyr, 2001).

• #15 Excoriation disorder – wikidoc

  https://www.wikidoc.org/index.php/Excoriation_disorder

  The prevalence of excoriation (skin-picking) disorder is approximately 1,400 per 100,000 (1.4%) individuals worldwide. […] About 2% of dermatology patients suffer from excoriation disorder. […] The age of onset for excoriation disorder is likely either under 10 years old or between 30 and 45 years old. […] The symptoms of excoriation disorder usually develop either under 10 years of age or between 30 and 45 years old.

• #16 Excoriation Disorder DSM-5 698.4 (L98.1)

  https://www.theravive.com/therapedia/excoriation-disorder-dsm–5-698.4-(l98.1)

  The prevalence of the condition is estimated between 1.4 and 5.4 per cent of the population. Community surveys have suggested that 4 to 5 per cent have skin-picking, while telephone surveys have found skin-picking to the point of causing lesions in 16 per cent and criteria for the diagnosis in 1 to 2 per cent, and 2 per cent of dermatology patients have skin excoriation. […] There is a marked female preponderance, and symptoms often begin with the onset of acne but persist after the acne resolves, or are associated with childhood traumatic experiences or follow adult stresses (DellOsso et al., 2006). […] Excoriation disorder is frequently comorbid with other psychiatric disorders, especially those involving mood and anxiety. Obsessive-compulsive disorders are disproportionately represented, and about 40 per cent have drug or alcohol use disorders. Skin-picking is more common in psychiatric inpatients than in the general population. About half of patients with body dysmorphic disorder and slightly less than 10 per cent of those with hair-pulling and obsessive-compulsive disorders also have skin picking (Stein et al., 2010).

• #17 Prevalence of pathological skin-picking in dermatological patients | CoLab

  https://colab.ws/articles/10.1016%2Fj.jpsychires.2022.01.035

  The prevalence of pathological skin-picking (PSP) has predominantly been studied in students and the community, but not yet in dermatological patients. However, those may be at increased risk of PSP because it is often triggered by the feel or look of the skin. Thus, its prevalence among patients with a physician-diagnosed dermatological disease remains to be determined. […] PSP as defined by SPS-R scores 7 was reported by 121 participants (26.3%). It was significantly more frequent in patients with atopic dermatitis (AD, OR = 3.23; 95% CI: 1.95-5.68) and psoriasis (OR = 1.64; 95% CI: 1.00-2.67), but less frequent in those with malignant epithelial skin tumors (OR = 0.10; 95% CI: 0.02-0.43). […] Our findings indicate that PSP affects about one in four patients with skin disease. In particular, individuals suffering from atopic dermatitis may represent a high-risk population for PSP deserving early recognition and adequate treatment.

• #18 Excoriation disorder – Wikipedia

  https://en.wikipedia.org/wiki/Excoriation_disorder

  Excoriation disorder has a high rate of comorbidity with other psychiatric conditions, especially with mood and anxiety disorders. […] One survey of patients with excoriation disorder found that 56.7% also had a DSM-IV Axis-I disorder and 38% had substance use problems. […] Studies have shown the following rates of psychiatric conditions found in patients with excoriation disorder: trichotillomania (38.3%), substance use disorder (38%), major depressive disorder (approximately 31.7% to 58.1%), anxiety disorders (approximately 23% to 56%), obsessive-compulsive disorder (approximately 16.7% to 68%), and body dysmorphic disorder (approximately 26.8% to 44.9%). […] There are also higher rates of excoriation disorder in patients in psychiatric facilities; a study of adolescent psychiatric inpatients found that excoriation disorder was present in 11.8% of patients.

• #19 Excoriation disorder – Wikipedia

  https://en.wikipedia.org/wiki/Excoriation_disorder

  It is also present at high rates with some other conditions: 44.9% of patients with body dysmorphic disorder also have excoriation disorder; 8.9% of patients with OCD have excoriation disorder; and 8.3% of patients with trichotillomania have excoriation disorder. […] Skin picking is also common in those with certain developmental disabilities; for example, Prader-Willi syndrome and Smith-Magenis syndrome. […] Studies have shown that 85% of people with Prader-Willi syndrome also engage in skin-picking. […] Children with developmental disabilities are also at an increased risk for excoriation disorder. […] Excoriation disorder also correlates with „social, occupational, and academic impairments, increased medical and mental health concerns (including anxiety, depression, obsessive-compulsive disorder) … and financial burden”.

• #20 Excoriation Disorder DSM-5 698.4 (L98.1)

  https://www.theravive.com/therapedia/excoriation-disorder-dsm–5-698.4-(l98.1)

  The incidence is also increased in developmentally disabled individuals, particularly those with Smith-Magenis and Prader-Willi syndromes. As many as 85 per cent of the latter may have skin-picking (Lang et al., 2010). Psychosocial morbidity is high, with marked increases in social and occupational disability, financial difficulty and medical problems (Stein et al., 2010).

• #21 International OCD Foundation | What is Skin Picking Disorder?

  https://iocdf.org/about-ocd/related-disorders/skin-picking-disorder/

  Skin picking disorder may affect as many as 1 in 20 people. […] Although it occurs in both men and women, research suggests that skin picking disorder occurs much more often in women. […] Skin picking disorder is currently classified as an impulse control disorder. […] Skin picking disorder is also sometimes referred to as an “obsessive compulsive spectrum disorder” (or “OC spectrum disorder”) because it shares features of OCD. […] People with skin picking disorder are more likely than people without it to have OCD and other OC spectrum disorders. […] Skin picking disorder can hurt a person emotionally, physically, and socially. […] In addition to feeling shame and embarrassment, people with skin picking disorder can have other psychological problems like depression and anxiety.

• #22 Phenomenology and Epidemiology of Pathological Skin Picking | The Oxford Handbook of Impulse Control Disorders | Oxford Academic

  https://dbpia.nl.go.kr/edited-volume/34532/chapter/292951590

  Pathological skin picking (PSP), or neurotic excoriation, is characterized by the repetitive and compulsive picking of skin, causing tissue damage. It appears to have a prevalence rate of 1.4%–5.4% in the general population and is seen predominantly in females in clinical settings. […] A recent telephone survey of 2511 adults ages 18 and older using random digit-dialing found that 16.6% picked their skin, resulting in noticeable tissue damage. This same survey found that when the additional requirements of distress or impairment were considered, 1.4% met criteria for PSP (Keuthen et al., 2010). Other studies have found that PSP may have rates as high at 5.4% in a community sample (n = 354; Hayes et al., 2009). […] Co-occurring PSP is also common in other psychiatric disorders and appears to be most prevalent in body dysmorphic disorder (BDD). In a sample of 176 patients with BDD, lifetime rates of PSP were found in 44.9% of patients (Grant, Menard, & Phillips, 2006). Other studies have found PSP rates of 26.3% secondary to BDD (Phillips & Taub, 1995). This is much higher than the rates of co-occurring PSP found in obsessive-compulsive disorder (OCD) subjects (8.9%; Grant, Menard, & Phillips, 2006) and trichotillomania subjects (8.3%; Odlaug & Grant, 2007), although even these rates are significantly higher than those seen in the general population and may suggest neurobiological similarities between these conditions.

• #23 SciELO Brazil – Comorbidity of psychiatric and dermatologic disorders with skin picking disorder and validation of the Skin Picking Scale Revised for Brazilian Portuguese Comorbidity of psychiatric and dermatologic disorders with skin picking disorder an

  https://www.scielo.br/j/rbp/a/FTmZvV9vskrRWzcb4PtCctc/

  The interface between dermatology and psychiatry poses a great challenge, especially when handling chronic pruriginous conditions. […] This study revealed that 37% of the patients with a diagnosis of SPD had some comorbid dermatosis, with acne (24%) and atopic dermatitis (15%) being most common. […] We conclude that the Brazilian version of the SPS-R has good psychometric properties and is a good instrument to assess the severity of SPD. […] We also conclude that patients with SPD are at increased risk for illness due to other psychiatric and dermatological disorders, so a multidisciplinary team should actively search for these diagnoses and pursue their treatment in these patients.

• #24 Skin Picking and Autoimmune Disorders

  https://www.verywellhealth.com/skin-picking-and-autoimmune-disorders-5324089

  Skin-picking disorder (dermatillomania or excoriation disorder) and autoimmune disorders often go together. […] Research suggests that skin picking is associated with certain mental health disorders such as anxiety and depression. It can also happen with autoimmune conditions. […] Some research suggests itchiness is a persistent symptom of many autoimmune connective-tissue diseases and is under-recognized and undertreated. This could make them prone to triggering excoriation. […] Research suggests around 3% of people have a current or past skin-picking disorder. People with excoriation disorder are significantly more likely to be female. […] Skin picking disorder is related to several autoimmune diseases, including rheumatoid arthritis, psoriasis, lupus, MS, and type 1 diabetes.

• #25 Skin Picking and Autoimmune Diseases: Signs and How to Treat

  https://www.healthline.com/health/skin-picking-and-autoimmune-disorders

  Excoriation disorder, also known as dermatillomania, is a skin-picking condition. […] A 2020 study suggests that excoriation disorder may affect 3 to 5 in every 100 people. Skin-picking disorder is statistically more common in women than in men. […] Autoimmune conditions that affect your skin can cause excoriation disorder to develop. This is more likely if you already have a history of other mental health or psychological conditions. […] Autoimmune disorders have been linked to excoriation disorder, a type of OCD. Underlying inflammation, itching, and rashes can lead to skin picking, which then progresses to compulsive behavior. For people who already have mental health conditions that put them at risk, autoimmune symptoms can trigger excoriation disorder.

• #26

  https://www.termedia.pl/Exploring-skin-picking-disorder-aetiology-treatment-r-nand-future-directions,7,54674,1,1.html

  Several demographic factors are now linked with a higher risk of developing skin picking disorder. While SPD can affect individuals from diverse backgrounds, certain demographic groups may be more vulnerable to the disorder. For example, individuals with a history of psychiatric conditions such as anxiety disorders, depression, or obsessive-compulsive disorder (OCD) may be at higher risk of developing SPD. Similarly, individuals with a history of trauma, abuse, or neglect may also be more susceptible to SPD. […] Age is another demographic factor that may influence the risk of developing SPD. As noted, while the disorder can manifest at any age, onset typically occurs during adolescence or early adulthood, coinciding with periods of increased stress and hormonal changes. Specific personality traits, such as perfectionism or neuroticism, have also been shown to play a role in increasing the risk of an individual developing SPD.

• #27

  https://www.termedia.pl/Exploring-skin-picking-disorder-aetiology-treatment-r-nand-future-directions,7,54674,1,1.html

  Socioeconomic factors may also contribute to the prevalence of SPD. Individuals from lower socioeconomic backgrounds often face additional stressors, such as financial strain or limited access to mental health resources, which could increase their risk of developing SPD. Furthermore, cultural factors and societal norms surrounding body image and grooming behaviours have been suggested as potential factors in the prevalence of SPD in different populations.

• #28 Excoriation disorder – Wikipedia

  https://en.wikipedia.org/wiki/Excoriation_disorder

  Excoriation disorder also has a high degree of comorbidity with occupational and marital difficulties. […] Substance use is often present, and individuals with excoriation disorder are twice as likely to have first-degree relatives who have substance use disorders than those without the condition. […] Some cases of body-focused repetitive behaviors found in identical twins also suggest a hereditary factor. […] In a 2020 Study of Excoriation to identify the variable’s such as: demographics, SES, marital status and gender, more than 75% of participants were identified as female, more than 45% of all participants were unemployed, and more than 60% had marital status which ranged from being single to divorced or widowed.

• #29 Skin Picking | Excoriation | BFRB

  https://www.bfrb.org/skin-picking

  Research indicates that approximately 2%-5% of the population picks their skin to the extent that it causes noticeable tissue damage and marked distress or impairment in daily functioning. […] Skin picking disorder is currently classified as Obsessive-Compulsive and Related Disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). […] The impact of skin picking disorder on one’s life may be significant. Individuals may experience shame and embarrassment and, as a result, may avoid certain social situations or activities (e.g., pools, gyms, beaches), and medical care. […] Medical complications as a result of skin picking disorder are not uncommon. Infection, which may require medical treatment, scabbing, open wounds, discoloration, scarring, or disfigurement are possible consequences of chronic skin picking behavior.

• #30 White Matter Abnormalities in Skin Picking Disorder: A Diffusion Tensor Imaging Study | Neuropsychopharmacology

  https://www.nature.com/articles/npp2012241

  Skin picking disorder (SPD) has an estimated prevalence rate ranging from 1.4 to 4.2% […] SPD typically begins in adolescence and is thought to be more common in women. Individuals with SPD may pick at any bodily site, but most frequently pick the face, arms and legs. The disorder subtends considerable functional impairment; a survey of 760 sufferers found that 48% picked at their skin for over 1h each day, 63% avoided socializing due to picking, 58% would not go out into public due to their picking, and one-third reported missing school or work frequently due to picking. There are also important medical sequelae of SPD, including infections, lesions, scarring, and serious physical disfigurement. In the most severe cases, individuals may be at heightened risk of mortality and warrant neurosurgical intervention.

• #31 An unusual complication of dermatillomania – Hawatmeh – Quantitative Imaging in Medicine and Surgery

  https://qims.amegroups.org/article/view/13747/html

  Dermatillomania or skin picking disorder (sometimes called excoriation disorder, neurotic picking, psychogenic excoriation) is characterized by repetitive skin picking leading to tissue damage. Skin picking may result in significant tissue damage and often leads to medical complications such as localized infections. […] Despite a lifetime prevalence of 1.4% in general population, Skin picking disorder is believed to be underreported. It is more commonly reported in females, with a median age of onset of 30-45 years. […] Due to its relative high prevalence and morbidity, it has been included lately in DSM-5. […] Skin picking may result in significant tissue damage and often leads to medical complications such as localized infections. The repetitive, excoriation nature of picking in severe cases may even warrant skin grafting. […] This case report illustrates the importance of skin examination and the recognition of skin findings in patients with skin picking disorder which is frequently underdiagnosed. Early diagnosis and appropriate treatment by physicians are essential to prevent potentially fatal consequences.

• #32 Common Misdiagnoses for Excoriation Disorder – Skin Picking Support

  https://www.skinpickingsupport.com/blog/common-misdiagnoses-for-excoriation-disorder/

  With excoriation disorder (aka skin picking, or, dermatillomania) only being recognized as an independent mental health disorder in 2013, misdiagnoses of this compulsion is still common. […] Although the behavior of someone with Morgellons is similar to excoriation disorder, the intention of the act differs greatly. […] To better categorize obsessions and compulsions, the DSM-5 includes a new Obsessive-Compulsive and Related Disorders section, where excoriation disorder is found. […] Although a simple blood test can determine if a persons skin picking is caused by using drugs (methamphetamine, heroin, etc), people who compulsively pick their skin can be mistaken for addicts, which creates more stigma and can lead to discrimination that results in poor healthcare treatment, or being dismissed with any health concern.

• #33 SciELO Brazil – Comorbidity of psychiatric and dermatologic disorders with skin picking disorder and validation of the Skin Picking Scale Revised for Brazilian Portuguese Comorbidity of psychiatric and dermatologic disorders with skin picking disorder an

  https://www.scielo.br/j/rbp/a/FTmZvV9vskrRWzcb4PtCctc/

  Skin picking disorder (SPD) affects up to 5.4% of the population. […] Less than half of patients are correctly diagnosed and treated. […] The sample had a high prevalence of psychiatric disorders, mainly generalized anxiety disorder (62.1%) and current (32.3%) and past (37.1%) depressive episodes. […] The severity of SPD is related to severity of depression, anxiety, and impairment in quality of life. […] The prevalence of psychiatric comorbidities was high, with 23% of all individuals evaluated by psychiatrists being excluded from the study due to severe psychiatric disorders. […] The most prevalent psychiatric illnesses were depressive and anxiety disorders. […] This study validated the Portuguese version of the SPS-R as a reliable instrument to be used in the Brazilian population.

• #34 A case report of an atypical severe case of skin picking disorder managed by a multidisciplinary team | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05712-4

  Skin picking disorder remains relatively common, it often does not present to psychiatry until significant morbidity or comorbidities are reached. […] There has been limited research in this specific disorder and treatment efficacy has often been poor in severe cases. […] Ultimately, only a small portion of patients seek help, noted to be due to reasons such as embarrassment, stigma, belief that it is a bad habit, or that it is untreatable. […] Despite a less than comprehensible approach to treatment or presentation of skin picking disorder, it remains a relatively common disorder, with prevalence estimating to range between 1.4 5.4%. […] The functional impact on these patients should not be underestimated as they may spend an impressive amount of time hiding this behaviour or performing the repetitive behaviour of picking.

• #35 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  Excoriation (skin-picking) disorder (ED), also known as dermatillomania, psychogenic excoriation, or neurotic excoriation, is characterized by recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. […] Skin-picking is quite common, with prevalence estimates of ED ranging between 1.4% and 5.4%. […] The majority of individuals seeking treatment for ED are female. […] It has been suggested that less than a fifth of patients seek treatment for their skin-picking. […] The literature systematically reviewed here, and previous meta-analyses, emphasize the relatively sparse evidence base, but also point to the benefit of behavioral treatments. […] SSRIs have been a mainstay of pharmacotherapy, but there is now evidence from a RCT that NAC should also be considered as a potential intervention.

• #36 SciELO Brazil – Comorbidity of psychiatric and dermatologic disorders with skin picking disorder and validation of the Skin Picking Scale Revised for Brazilian Portuguese Comorbidity of psychiatric and dermatologic disorders with skin picking disorder an

  https://www.scielo.br/j/rbp/a/FTmZvV9vskrRWzcb4PtCctc/

  The SPS-R, being self-reported, can be used by all these professionals, even if they are not psychiatrists, dermatologists, or psychologists, providing a reasonable tool to increase assessment of SPD diagnosis and severity, overcoming the barrier of low referral to treatment. […] Our findings also demonstrate that the severity of SPD is related to the severity of anxiety and depression, as assessed by two validated instruments (GAD-7 and PHQ-9), which is in accordance with the literature. […] It is likely that comorbidities are both a cause and consequence of higher SPD severity, and treating both leads to better outcomes. […] Although up to 70% of patients with SPD experience significant impairment in their quality of life, this problem is often underestimated, with up to 85% of patients seeking cosmetic interventions first and less than 20% seeking professional help, probably because both providers and patients are unaware of the treatment options available for SPD.

• #37 Epidemiology and Comorbidities of Excoriation Disorder: A Retrospective Case-Control Study

  https://www.mdpi.com/2077-0383/9/9/2703

  The high burden of psychiatric disorders observed in our study is consistent with prior reports suggesting a close relationship between ED and psychiatric disease. […] Despite the imperative for a multidisciplinary approach involving dermatologic and psychiatric care in ED management, less than half of ED patients in our study were referred to psychiatry. […] Currently, there are no pharmacological treatments approved by the US Food and Drug Administration (FDA) for this condition and the pathophysiology of ED is unknown. […] Further multicentered, prospective studies are needed to better understand the disease pathophysiology and effective treatment methods.

• #38 Antioxidant Therapies for Ulcerative Dermatitis: A Potential Model for Skin Picking Disorder | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0132092

  Formal studies of NAC efficacy in Skin Picking Disorder are currently limited to open-label case reports. […] These data lend support to the role of oxidative stress in both Skin Picking Disorder and UD, and encourage investigation of intranasal GSH as a novel therapy for human Skin Picking Disorder.

• #39 A case report of an atypical severe case of skin picking disorder managed by a multidisciplinary team | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05712-4

  Healthcare providers need to be aware that skin picking disorder can have significant impact on a patients life. […] Severe cases should be referred to a psychiatrist specialist service and due to the level of mortality, comorbidity and even mortality that can be associated with this, may even need to be prioritized as urgent.

• #40 White Matter Abnormalities in Skin Picking Disorder: A Diffusion Tensor Imaging Study | Neuropsychopharmacology

  https://www.nature.com/articles/npp2012241

  Analysis of DTI data identified multiple white-matter regions with significantly reduced FA in patients with SPD vs controls. These abnormal regions involved distributed tracts, maximal in the region of the bilateral anterior cingulate cortices, but also including white matter in proximity of the left temporoparietal junction. […] Even with a long history in the medical literature, the neurobiology of SPD has received little research attention. To our knowledge, this is the first neuroimaging study of individuals with SPD. The key finding was that SPD was associated with reduced integrity of distributed white-matter tracts connecting the anterior cingulate cortices to other neural nodes bilaterally. […] These findings add considerable support to the notion that in addition to the phenomenological and comorbid overlap between SPD and trichotillomania, these disorders likely share overlapping neurobiology.

• #41 Interactive Journal of Medical Research – Patterns of Skin Picking in Skin Picking Disorder: Ecological Momentary Assessment Study

  https://www.i-jmr.org/2024/1/e53831/

  Skin picking disorder (SPD) is an understudied mental illness that is classified as a body-focused repetitive behavior disorder. Literature suggests that pathological skin picking is strongly integrated into the daily lives of affected individuals and may involve a high degree of variability in terms of episode characteristics, frequency, and intensity. […] With a lifetime prevalence of 1.4% to 3.1%, SPD is not a rare disorder, even though it received comparatively little attention in research and clinical practice so far. […] Until now, there has been little research on the phenomenology of SPD, and the existing research is of questionable validity as it often entails retrospective reporting, so the clinical picture has not been described in sufficient detail to date. This hinders a well-grounded understanding of the disorder as well as the development of specific treatment options.

• #42 Skin picking disorder | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/12/clinical-review/skin-picking-disorder

  The diagnosis requires significant emotional distress or impaired functioning in at least one important area of life (academic, occupational or social). […] The diagnosis of skin picking disorder should not normally be used if the skin picking is better explained by other disorders. […] Research is needed to find out more about the effect of psychological treatment and which patients benefit the most or should be prioritised.

• #43 Prevalence and risk factors for SPD symptoms | CCID

  https://www.dovepress.com/prevalence-of-and-risk-factors-for-skin-picking-disorder-symptoms-amon-peer-reviewed-fulltext-article-CCID

  Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. Given the paucity of information on SPD symptoms, their prevalence, and risk factors in Saudi Arabia, the present study seeks to fill this gap by investigating these factors in a community sample from Jeddah. […] The prevalence of SPD ranges from 1.4% to 5.4%. […] The disorder is particularly common during adolescence, often coinciding with the onset of puberty. […] Studies in community samples indicate that skin picking is common and often occurs in conjunction with other psychiatric disorders. […] The present study found that skin picking disorder symptoms are not rare among the adult population of Jeddah, particularly in vulnerable groups such as those with depression and those who are widowed, divorced, separated, or single. […] More research, particularly longitudinal studies, is needed to further examine the causes and outcome of skin picking behavior.

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