Excoriation disorder

Background and aims: Pathological skin-picking (PSP) or excoriation disorder is a destructive behavior that affects 1-2% of the general population. The purpose of this pilot study was to evaluate the effect of a computerized behavior modification task on action-tendencies (i.e., approach or avoidance) in adults with PSP. We aimed to modify these action-tendencies by having participants with PSP complete the Approach-Avoidance Training (AAT) task, using a joystick to simulate an approach (=pull) or avoidance (=push) response...

Aim: Skin-picking (excoriation) disorder is considered as a form of maladaptive coping methods used by individuals who have difficulties in applying more adaptive strategies. Skin-picking development has been suggested to be preceded by traumatic life events. Dissociative symptoms have been reported as experienced by skin-picking sufferers during picking episodes. The purpose of the study was to examine whether the link between trauma and automatic type of skin-picking is mediated by the frequency of dissociative experiences, and whether the COVID-19 pandemic conditions have changed this relationship in any way...

OBJECTIVE: Excoriation disorder is a disabling behavioral disorder characterized by compulsive and repetitive picking of the skin. Excoriation disorder has a lifetime prevalence of 3% to 5% in the general population, and it is most common in females. Its course is chronic, and it is characterized by fluctuating and frequent periods of exacerbation. Excoriation disorder is commonly comorbid with several psychiatric disorders. The treatment of this disorder is challenging and requires a multidisciplinary approach...

Excoriation disorder (skin picking disorder, SPD) is an illness that is included in the classification of mental disorders since DSM-5. Despite a prevalence of 1.4-5.7% in the general population, this is a not well-known condition among dermatologists and psychiatrists. We describe a case of a man who lost all upper incisors and canines as a result of a severe form of SPD. We provide an overview of the treatment options and call for increased attention for this condition.

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BACKGROUND: Recognizable skin findings of child physical abuse include bruises, abrasions, lacerations, bite marks, burns, and oral injuries. Self-induced skin picking, or neurotic excoriation, can correspond to emotional stress, underlying psychiatric illness, or substance abuse. Parental neurotic excoriation injury of children has not been reported previously as a form of physical abuse. METHODS: We present a case series of five children abused via parental excoriation...

BACKGROUND/OBJECTIVES: Neonatal abstinence syndrome (NAS) incidence continues to rise in the United States due to increasing opioid use disorder in pregnancy. While cutaneous excoriations have been noted in NAS, there is a paucity of literature regarding abnormal nail findings in NAS. METHODS: A retrospective, observational case series was conducted of twelve patients with NAS and abnormal nail findings who were admitted to the neonatal intensive care unit between January 1, 2018, and May 1, 2020...

INTRODUCTION: Bullous pemphigoid (BP) is an autoimmune disease that typically presents with blisters, but sometimes early lesions may be eczematous, maculopapular, or urticarial. The aim of the present study was to highlight possible differences between typical bullous and non-bullous pemphigoid (NBP) and compare results with the literature. Material & methods: Patients receiving a diagnosis of BP between January 2000 and December 2019 were analyzed. Patients who developed a blister after 3 months from the onset of pruritus were considered as NBP...

A plethora of health-related concerns, including skin disorders, are particularly common during the critical periods of adolescence and young adulthood. Their reactions to skin-related disorders can be different from their reactions to other disorders. While medical problems could be physiologically impacting, skin disorders like excoriation disorder can, in addition, directly affect their physical appearance in ways that have psychological consequences like anxiety, low self-esteem, and impaired quality of life...

BACKGROUND: Amyand's hernia was an unusual condition defined by the presence of an appendix located in the inguinal hernia sac. Its prevalence was 1% of all inguinal hernia in children. The clinical manifestation of Amyand's hernia was depending on hernia's stage, an incarcerated hernia will present with an inguinal mass following by pain and motility disorder. It could lead to abdominal distention in the late stage. The common location of Amyand's hernia was on the right side, the left side was uncommon...

Bullous pemphigoid (BP) is the most prevalent autoimmune blistering skin disease in the Western world affecting mainly the elderly population. The diagnosis is based on clinical assessment along with specific immunopathologic findings on skin biopsy. Risk factors include genetic factors, environmental exposures, and several infections including hepatitis B, hepatitis C, Helicobacter pylori , Toxoplasma gondi , and cytomegalovirus. A variety of drugs have been associated with BP including but not limited to dipeptidyl peptidase-4 inhibitors, loop diuretics, spironolactone, and neuroleptics...

Currently, psychodermatological disorders are classified under different criteria exhibiting several limitations, and no single universal classification system exists. Herein, we discuss previous suggested classifications in psychodermatology, highlighting their limitations, and we propose a new classification system, without redundant information and with accurate terminology, incorporating the relevance of the terms "disorder," "disease," and "illness" in psychodermatology. In this new classification, the following three groups are then suggested: "primary psychodermatological disease," to include primary dermatoses, where psychological stress, a psychological mechanism, and/or psychopathology are some of the main elements that are recognized in the etiopathogenesis (which may induce and/or worsen a primary dermatosis); "primary psychodermatological illness," to include skin symptoms, with or without secondary self-induced skin lesions (such as excoriations), without a primary dermatosis, and where psychopathology, psychological characteristics, and/or a neuropathic mechanism, where stress plays a relevant role, are key features responsible for the skin symptoms and the secondary skin lesions; and "secondary psychodermatological disorder," to include medications prescribed in dermatology with psychiatric consequences and medications prescribed in psychiatry with dermatologic consequences...

Acne vulgaris is one of the most common dermatologic disorders affects people of all races and ethnicities and has many adverse effects on the quality of life. The increased bacterial resistance to antibiotics has reduced the effectiveness of treatment with these agents. There is an increasing focus on the involvement of oxidative stress in the pathophysiology of acne. This study investigates the effect of N-acetylcysteine (NAC) as an antioxidant in the treatment of acne vulgaris. This systematic review was conducted through a search in databases such as Science Direct, PubMed, Scielo, and Medline using keywords including acne vulgaris, anti and NAC, and all the keywords associated with each of the subtitles...

Somatic manifestations of mental illness sometimes occur in patients presenting to hand specialists. These conversion disorders can also occur in groups, a phenomenon known as "mass psychogenic illness." The increasing penetrance of the Internet and social media in modern society has greatly facilitated the interaction of patients with others with similar disorders. One example relevant to hand surgery is "Morgellons disease," a disorder popularized in 2002 and characterized by a firm belief in foreign material extruding from the skin, leading to nonhealing, self-inflicted ulcerations and excoriations...

Atopic dermatitis (AD) is a chronic skin disorder characterized by pruritus, erythema and excoriation. While AD has a multifactorial etiology, neuro-signaling pathways are now recognized to play an essential role in the pathogenesis of AD, particularly pruritus. Neuromodulators, such as topical naltrexone, are being utilized in AD treatment. Another class of neuromodulator, Palmitoylethanolamide (PEA), has demonstrated effectiveness in the treatment of itch, excoriation and erythema in AD patients. Phytocannabinoids including cannabidiol (CBD) are becoming increasingly accessible to the public and continue to be advertised for their efficacy to treat inflammatory skin disorders such as eczema...

Body-focused repetitive behavior disorders (BFRBs) include Trichotillomania (TTM; Hair pulling disorder) and Excoriation (Skin Picking) Disorder (SPD). These conditions are prevalent, highly heterogeneous, under-researched, and under-treated. In order for progress to be made in optimally classifying and treating these conditions, it is necessary to identify meaningful subtypes. 279 adults (100 with TTM, 81 with SPD, 40 with both TTM and SPD, and 58 controls) were recruited for an international, multi-center between-group comparison using mixture modeling, with stringent correction for multiple comparisons...

Obsessive-compulsive and related disorders (OCRDs), sometimes referred to as obsessive-compulsive spectrum disorders, cause significant impairment and share similar features across several domains, including clinical course, risk factors, and response to treatment. Generally, individuals meeting criteria for one or more OCRDs present with symptoms focused on preoccupations and repetitive behaviors. Sex differences emerge in the clinical presentation of OCRDs, and the associated. Literature emphasizes the importance of considering sex when investigating causal factors, prognosis, and outcomes of OCRDs...

Atopic dermatitis (AD) is a common inflammatory skin disease, clinically characterized by recurrent eczematous lesions and intense itching, leading to excoriations and susceptibility to cutaneous infections. Although it is considered a pediatric disorder, mainly starting in infancy, it is also very common in adults. Etiology of AD is complex and multifactorial: interaction between genetic susceptibility and environment, but also cutaneous barrier impairment, change in microbiome composition and innate and adaptive immune dysregulation are the main factors involved in the pathogenesis of the disease...

Langerhans cell histiocytosis (LCH) is an infrequent clonal proliferative disorder of myeloid dendritic cells. It has a wide variety of cutaneous manifestations and retains the possibility of systemic implications. Because LCH is predominantly a disease of childhood, there are well-established clinical definitions, as well as guidelines regarding workup and treatment, in the context of pediatric disease. Here we present a case of isolated cutaneous LCH in an adult male, followed by a discussion of our diagnostic plan and treatment course...

Actinic prurigo is a rare, idiopathic chronic photodermatosis of childhood characterized by excoriated papules, nodules, and plaques in sun-exposed areas. It is notoriously difficult to treat. The disorder involves a type IV hypersensitivity reaction driven by both Th1 and Th2 inflammatory pathways, the latter of which leads to secretion of IL-4, IL-5, IL-13, and production of B cells, IgE, and IgG4. Dupilumab, an IL-4 receptor antagonist, disrupts the Th2 pathway. We present a pediatric patient with severe, recalcitrant actinic prurigo who achieved rapid and sustained clearance with dupilumab...