Abstract
Manipulation of the skin is ubiquitous in most individuals along a spectrum of extent
and severity. Skin picking that results in clinically evident changes or scarring
to the skin, hair, and nails or significantly impairs intrapsychic, psychosocial,
or occupational function is considered pathological picking. Several psychiatric conditions
are associated with skin picking, including obsessive-compulsive disorder, body-focused
repetitive behaviors, borderline personality disorder, and depressive disorder. It
is also associated with pruritus and other dysesthetic disorders. Although pathologic
skin picking, also known as excoriation disorder, is a distinct diagnosis in the Diagnostic
and Statistical Manual of Mental Disorders (DSM5), this review attempts to further
classify the diagnosis into the following eleven picker categories: organic/dysesthetic,
obsessive-compulsive, functionally autonomous/habit, anxious/depressed, attention
deficit hyperactivity disorder, borderline, narcissistic, body dysmorphic, delusional,
guilty, and angry picker. An organized conceptualization of skin picking can guide
providers towards a constructive management approach, ultimately increasing the likelihood
of successful therapeutic outcomes.
Keywords
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Article info
Publication history
Publication stage
In Press Accepted ManuscriptFootnotes
Funding: This study did not receive any funding.
Statement of disclosure: None declared.
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© 2023 Elsevier Inc. All rights reserved.
