REVIEW  PSYCHOCUTANEOUS DISEASES 

Giornale Italiano di Dermatologia e Venereologia 2018 August;153(4):516-24

DOI: 10.23736/S0392-0488.18.05980-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Skin excoriations: picking apart the picker

Richard G. FRIED ¹ ✉, George KROUMPOUZOS ^{2, 3}

¹ Yardley Dermatology and Yardley Clinical Research Associates, Yardley, PA, USA; ² Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA; ³ Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil

Management of patients who pick at their skin can be challenging. Etiologies and maintaining factors of skin picking are often unclear. Significant psychiatric overlay is often present, and the clinician is left with an overwhelming differential diagnosis and poorly focused management plans which can result in suboptimal clinical outcomes. The purpose of this article is to provide a conceptual framework for the evaluation and treatment of a patient presenting with excoriations. Ten diagnostic categories of pickers are described, and specific suggestions for treatment are offered.

KEY WORDS: Skin diseases - Neurotic disorders - Obsessive-compulsive disorder - Disease management - Therapeutics