86 results match your criteria Neurotic Excoriations

Factitial dermatitis in the hospital setting.

Arch Dermatol Res 2022 Jan 25. Epub 2022 Jan 25.

Division of Dermatology, Department of Internal Medicine, The Ohio State University, 1328 Dublin Road, Suite 100, Columbus, OH, 43212, USA.

Factitial Dermatitis (FD) is a notoriously difficult disease to diagnose, as patients produce self-induced cutaneous lesions and provide an inadequate or inaccurate history. We performed a cross-sectional study, querying an inpatient consultation database of all patients admitted to the Ohio State University Wexner Medical Center from 2012 to 2017 with a dermatologic ICD as a discharge diagnosis. Our exhaustive keyword search produced 189 candidates. Read More

View Article and Full-Text PDF
January 2022

Implementation of a psychodermatology clinic at a major health system in Detroit.

Int J Womens Dermatol 2018 Dec 7;4(4):227-229. Epub 2018 Jul 7.

Henry Ford Medical Center, Department of Dermatology, Detroit, Michigan, United States.

The association between psychiatric and dermatologic disorders has been well characterized in the present literature with estimates of up to 40% of dermatology patients having concomitant psychiatric problems that are often related to their skin condition. Here, we present our experience regarding the implementation of a psychodermatology clinic in Detroit, Michigan. The most commonly referred conditions were delusions of parasitosis, neurotic excoriations, and isotretinoin initiation for patients with a history of psychiatric conditions. Read More

View Article and Full-Text PDF
December 2018


Acta Med Croatica 2016 ;70 Suppl 1:35-8

Psychodermatologic disorders are conditions involving an interaction between the mind and the skin. Correlation between psychiatric and dermatological disorders is a highly complex relation considering etiology, diagnostic procedures and treatment. There are three major groups of psychodermatological disorders: psychosomatic (psychophysiologic) disorders, primary psychiatric disorders and secondary psychiatric disorders. Read More

View Article and Full-Text PDF
November 2017

Skin changes in primary psychiatric disorders.

Acta Dermatovenerol Croat 2015 ;23(2):87-95

Professor Aleksandra Basta-Juzbašić, MD, PhD, Department of Dermatology and Venereology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Šalata 4, 10000 Zagreb, Croatia;

Primary psychiatric disorders where skin changes appear most frequently include: delusions of parasitosis, body dysmorphic disorder, neurotic excoriations, dermatitis artefacta, and trichotillomania. In all these diseases the primary pathologic condition is of psychiatric nature, and the skin changes are secondary and self-induced. In this review we wanted to present the epidemiology, clinical pictures, and treatment options for these disorders. Read More

View Article and Full-Text PDF
January 2017


Adv Psychosom Med 2015 30;34:123-34. Epub 2015 Mar 30.

University of Arizona, College of Medicine, Tucson, Ariz., USA.

Psychodermatology is an underappreciated field that studies psychocutaneous disorders, which are conditions that have both dermatologic and psychiatric characteristics. Underlying psychiatric comorbidity is estimated to occur in up to one-third of dermatologic patients, and psychiatric illness may either be the cause or the consequence of dermatologic disease. Psychodermatologic patients lack insight and often do not recognize a psychiatric etiology for their symptoms and therefore comprise some of the most challenging cases to treat. Read More

View Article and Full-Text PDF

Obsessive-compulsive behaviour related cutaneous ulcers: two cases with therapeutic considerations.

Int Wound J 2016 Oct 14;13(5):860-2. Epub 2015 Jan 14.

Department of Pathology, Dental School, University of São Paulo, São Paulo, Brazil.

Obsessive-compulsive-related cutaneous disease most often includes trichotillomania, neurotic excoriations and nail biting. In this report, we present two cases of self-inflicted severe wounds that were diagnosed as secondary to obsessive-compulsive behaviour. Patients were middle-aged females who presented with deep cutaneous ulcers that were acknowledgedly maintained through repetitive manipulation. Read More

View Article and Full-Text PDF
October 2016

Augmentation of Venlafaxine with Aripiprazole in a Case of Treatment-resistant Excoriation Disorder.

Innov Clin Neurosci 2014 Jan;11(1-2):29-31

Mr. Turner is a third year medical student, Ms. Sutton is a fourth year medical student, and Dr. Sharma is Associate Professor of Consult/Liaison Psychiatry; all from University of Nebraska Medical Center, Psychiatry Department, Omaha, Nebraska.

We present a case of a 21-year-old woman with excoriation disorder that was resistant to currently reported treatment options. Severe lesions were present on multiple sites of her body. The skin picking appeared to be associated with anxiety surrounding her current medical stay and medical condition. Read More

View Article and Full-Text PDF
January 2014

Dermatologic manifestations of fibromyalgia.

Clin Rheumatol 2014 Jul 14;33(7):1009-13. Epub 2014 Jan 14.

Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

The aim of this study was to determine the common dermatologic diagnoses and skin-related symptoms in a cohort of patients with fibromyalgia seen in a tertiary referral center. A retrospective chart review was performed of all patients with a fibromyalgia diagnosis from January 1 to December 31, 2008, whose diagnosis was confirmed in the Fibromyalgia and Chronic Fatigue Clinic at Mayo Clinic in Rochester, Minnesota. Charts were reviewed for dermatologic conditions and cutaneous symptoms. Read More

View Article and Full-Text PDF

Neurotic excoriations and dermatitis artefacta.

Semin Cutan Med Surg 2013 Jun;32(2):95-100

Keck School of Medicine, University of Southern California, Los Angeles, USA.

Neurotic Excoriations is a psychocutaneous disorder that is characterized by an uncontrollable urge to pick at normal skin or skin with mild irregularities. Dermatitis Artefacta is another psychocutaneous disorder that consists of self-induced skin lesions often involving a more elaborate method for damaging the skin, such as the use of a sharp instrument. Both neurotic excoriations and dermatitis artefacta cause significant disfigurement and anxiety for the patient. Read More

View Article and Full-Text PDF

Primary psychiatric conditions: dermatitis artefacta, trichotillomania and neurotic excoriations.

Indian J Dermatol 2013 Jan;58(1):44-8

School of Medicine, University of Utah, Salt Lake City, UT, San Francisco, California ; Department of Dermatology, University of California, San Francisco, California, USA.

Primary psychiatric conditions encountered in dermatology include dermatitis artefacta, trichotillomania (TTM) and neurotic excoriations. For these disorders, the primary pathologic condition involves the psyche; therefore, any cutaneous findings are self-induced. Herein, we review common primary psychiatric conditions in dermatology - dermatitis artefacta, neurotic excoriations and TTM - and examine their epidemiology, clinical presentation, differential diagnosis and treatment strategies. Read More

View Article and Full-Text PDF
January 2013

Self-inflicted lesions in dermatology: terminology and classification--a position paper from the European Society for Dermatology and Psychiatry (ESDaP).

Acta Derm Venereol 2013 Jan;93(1):4-12

Department of Psychosomatic Medicine, Justus Liebig University, Giessen, Germany.

The terminology, classification, diagnosis and treatment of self-inflicted dermatological lesions are subjects of open debate. The present study is the result of various meetings of a task force of dermatologists, psychiatrists and psychologists, all active in the field of psychodermatology, aimed at clarifying the terminology related to these disorders. A flow chart and glossary of terms and definitions are presented to facilitate the classification and management of self-inflicted skin lesions. Read More

View Article and Full-Text PDF
January 2013

Emotional regulation, dissociation, and the self-induced dermatoses: clinical features and implications for treatment with mood stabilizers.

Clin Dermatol 2013 Jan-Feb;31(1):110-7

Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, 585 Springbank Dr, Suite 101, London, ON, N6J 1H3, Canada.

The self-induced dermatoses (such as trichotillomania, pathologic skin picking or neurotic excoriations, dermatitis artefacta, onychophagia and onychotillomania), which are caused as a result of excessive manipulation of the skin, hair, and nails by the patient, can contribute to significant morbidity and can even complicate the course of a primary dermatologic condition such as acne (eg, in acne excoriée) and some pruritic dermatoses. Reports on the self-induced dermatoses in the past decade have tended to focus upon the specific motor behaviors involved in self-inducing the lesions (ie, skin picking or hair pulling) rather than address the common psychopathologic factors underlying the self-injurious behaviors. In the current psychiatric nosology (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) the self-induced dermatoses are classified as Impulse Control Disorders and Stereotypic Movement Disorders, and this classification does not adequately consider the fact that in most patients with self-induced dermatoses, the frequency and severity of the self-injurious behaviors are directly related to acute or chronic problems with emotional regulation and dissociation. Read More

View Article and Full-Text PDF

The influence of reduction mammaplasty on dermato-psychiatric disorders.

Eurasian J Med 2012 Aug;44(2):68-72

Department of Plastic Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey.

Objective: Macromastia can cause psychiatric disorders, such as anxiety and depression, and decreases in self-esteem and self-confidence. These problems often externalize themselves on the skin, causing lesions characterized by various degrees of excoriations and lichenified plaques. Mammaplasty operations are very effective in the treatment of neurotic excoriations and similar skin lesions as well as any underlying psychiatric disorders. Read More

View Article and Full-Text PDF

[Hypochondria sine materia as a psychosomatic problem: a model of hypochondriac disorders realized in the cutaneous sphere].

Zh Nevrol Psikhiatr Im S S Korsakova 2012 ;112(1):14-25

Hypochondria sine materia is a disorder with physical complains corresponding to no any somatic diagnosis. Hypochondria sine materia is a more complicated psychopathological condition compared to hypochondria cum materia. Hypochondria sine materia could be diagnosed not only in psychiatry, but mainly in general medicine. Read More

View Article and Full-Text PDF

Neurotic excoriations: a diagnosis of exclusion.

J Clin Aesthet Dermatol 2012 Feb;5(2):63-4

The Ohio State University Medical Center, Division of Dermatology, Columbus, Ohio.

Patients with psychiatric disease may use the skin as a means of communication during times of increased emotional distress. Furthermore, a high incidence of skin disorders among patients with a primary psychiatric condition, including depression, schizophrenia, and anxiety, has been demonstrated, with neurotic excoriation being one of the most commonly diagnosed. Despite the strong association and incidence of psychogenic excoriation in patients with a primary psychiatric disorder, it is important for primary care physicians and dermatologists alike to realize that these patients may have true dermatological disease. Read More

View Article and Full-Text PDF
February 2012

Psychogenic skin excoriations: diagnostic criteria, semiological analysis and psychiatric profiles.

Acta Derm Venereol 2012 Jul;92(4):416-8

Department of Dermatology, European University of Brittany, University of Brest, University Hospital, FR-29609 Brest, France.

Psychogenic excoriations are also called neurotic excoriations, dermatillomania or skin picking syndrome. We proposed diagnostic criteria and then performed a study of the psychiatric profiles of outpatients with psychogenic excoriations and the circumstances around the creation of these excoriations. Although the results must be interpreted with caution because the study was performed with only 10 patients, interesting data is provided about the onset of psychogenic excoriations, the behaviour of picking, and comorbidity. Read More

View Article and Full-Text PDF

Neurotic excoriations.

Michael B Brodin

J Am Acad Dermatol 2010 Aug;63(2):341-2

View Article and Full-Text PDF

The knowledge, awareness, and practice patterns of dermatologists toward psychocutaneous disorders: results of a survey study.

Int J Dermatol 2010 Jul;49(7):784-9

Department of Psychiatry & Behavioral Sciences, Division of Child & Adolescent Psychiatry, University of Washington School of Medicine, Seattle, WA, USA.

Background: To assess the level of training in, and awareness and attitude about, psychocutaneous disorders among dermatologists.

Methods: A mail-in survey was sent to all members of Washington State Dermatology Society, who were requested to provide information on demographic variables; level of training, skills, and degree of comfort in managing psychodermatologic disorders; referral patterns, knowledge of patient and family resources on psychodermatology; and interest in continuing medical education on psychocutaneous disorders.

Results: Of 237 mailed surveys, 102 were returned for analysis. Read More

View Article and Full-Text PDF

Unna sleeve for neurotic excoriations.

Cutis 2010 Mar;85(3):149-52

Department of Dermatology, University of Pittsburgh, Pennsylvania 15213, USA.

Neurotic excoriations are self-induced skin lesions produced because of compulsive scratching or picking. We present the successful use of the venerable technique of an Unna boot used as an Unna sleeve for neurotic excoriations of the upper extremities. Read More

View Article and Full-Text PDF

Toward a better understanding of "psychocutaneous disorders".

David J Elpern

Int J Dermatol 2009 Dec;48(12):1395-6

The Skin Clinic, 12 Meadow Street, Williamstown, MA 01267, USA.

There is a group of cutaneous disorders for which we have an inadequate understanding of their etiology and which frustrates us as therapists. This includes conditions such as the dynias, neurotic excoriations, postherpetic neuralgia, prurigo nodularis, and others. Herein, we review a recent article in the New Yorker magazine which postulates a new way to look at these puzzling entities. Read More

View Article and Full-Text PDF
December 2009

[Self-inflicted dermatitis: a case in pediatric age].

Minerva Pediatr 2008 Jun;60(3):355-9

Istituto Dermopatico dell'Immacolata IDI, IRCCS Roma, Rome.

The skin is an organ that has a primary function in the tactile receptivity and also reacts significantly to emotional stimuli. The high visibility of the dermatological diseases makes the skin a privileged target for feelings and actions that reflect behavioural problems. The tendency to self-harm can be expressed with remarkable frequency through dermatological lesions; among them neurotic excoriations are a clinical frame in which patients, unlike for other ''similar'' pathologies, succeed however in recognizing their own role in the development of the cutaneous lesions. Read More

View Article and Full-Text PDF

Trigeminal trophic syndrome.

South Med J 2007 Jan;100(1):43-8

Baylor College of Medicine, USA.

Ulceration of the nose may be inadvertently induced by the patient. Although trigeminal trophic syndrome is an uncommon cause of chronic ulcers, healthcare providers should consider the possibility of this disorder when encountering a patient with nasal ulcerations. Trigeminal trophic syndrome most commonly occurs in older women following therapy for trigeminal neuralgia. Read More

View Article and Full-Text PDF
January 2007

Factitial dermatoses in children.

Curr Opin Pediatr 2006 Aug;18(4):403-9

Section of Pediatric Dermatology, Children's Hospital of Philadelphia, PA 19104, USA.

Purpose Of Review: Factitial skin diseases are characterized by unusual patterns of skin lesions that do not conform to any known dermatologic condition and that are consciously or subconsciously fabricated by the patient. This review summarizes the current literature regarding the diagnosis and management of factitial dermatoses in children.

Recent Findings: Neurotic excoriations, acne excoriee and trichotillomania are the most common factitial skin diseases seen in children. Read More

View Article and Full-Text PDF

Psyche, opioids, and itch: therapeutic consequences.

Dermatol Ther 2005 Jul-Aug;18(4):314-22

Department of Medicine, University of California, San Francisco (USCF), CA, USA.

A patient's psychological condition can substantially affect the presence and severity of pruritus, a phenomenon thought to be mediated by the central nervous system's (CNS) opioid neurotransmitter system. Specific psychodermatologic disorders associated with psychogenic pruritus, including depression, anxiety, chronic tactile hallucinations, delusions of parasitosis, neurotic excoriations, and other cutaneous compulsions are likely controlled by this pathway. Therefore, in treating these conditions, medications specifically directed at the CNS can be the most effective therapies, whereas topical and supportive therapy may be important adjuncts in targeting the associated pruritus. Read More

View Article and Full-Text PDF

Psychologic trauma, posttraumatic stress disorder, and dermatology.

Dermatol Clin 2005 Oct;23(4):649-56

Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.

Psychologic trauma refers to events (such as sexual assault, major earthquake, or plane crashes) that overwhelm an individual's capacity to cope. Psychologic trauma can result in chronic and recurring dermatologic symptoms that persist after the trauma subsides. Examples are cutaneous sensory flashbacks (which may be fragments of the sensory component of the traumatic experience), autonomic hyperarousal (with symptoms such as profuse sweating or flare-up of an underlying stress-reactive dermatosis), conversion symptoms (such as numbness, pain, or other medically unexplained cutaneous symptoms), and cutaneous self-injury (manifesting in many forms, including trichotillomania, dermatitis artefacta, and neurotic excoriations--tension-reducing behaviors in patients who have posttraumatic stress disorder). Read More

View Article and Full-Text PDF
October 2005

Excoriations and ulcers on the arms and legs.

J Fam Pract 2004 Sep;53(9):713-6

University of Texas Health Sciences Center at San Antonio, Dept of Family and Community Medicine, MC 7794, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.

View Article and Full-Text PDF
September 2004

Using hypnosis to facilitate resolution of psychogenic excoriations in acne excoriée.

Am J Clin Hypn 2004 Jan;46(3):239-45

Division of Dermatology and Cutaneous Surgery, MDC 079, College of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, Florida 33612, USA.

Hypnotic suggestion successfully alleviated the behavioral picking aspect of acne excoriée des juenes filles in a pregnant woman who had been picking at the acne lesions on her face for 15 years. Acne excoriée is a subset of psychogenic or neurotic excoriation. Conventional topical antibiotic treatment was used to treat the acne. Read More

View Article and Full-Text PDF
January 2004

Topiramate attenuates self-injurious behaviour in Prader-Willi Syndrome.

Int J Neuropsychopharmacol 2002 Jun;5(2):141-5

Department of Psychiatry, Evelyn F and William L McKnight Brain Institute of the University of Florida, Gainsville 32610-0256, USA.

Self-injurious behaviour (SIB), most notably skin picking, has been described by various terms in the literature ranging from neurotic/psychogenic excoriations to compulsive/pathological skin picking. Prader-Willi Syndrome (PWS) is a neurogenetic multisystem disorder characterized by infantile hypotonia, mental retardation, short stature, hypogonadism, dysmorphic features, and hyperphagia with a high risk of obesity. Psychiatric manifestations include SIBs in the form of skin picking, nail biting and rectal gouging. Read More

View Article and Full-Text PDF

Nonpharmacologic treatments in psychodermatology.

Richard G Fried

Dermatol Clin 2002 Jan;20(1):177-85

The author believes that psychocutaneous medicine has indeed come of age and is being incorporated into mainstream medical practice. Patients presenting to dermatologists today are more sophisticated and are frequently dissatisfied with traditional medical therapies. They actively seek alternative approaches and adjuncts to standard treatments. Read More

View Article and Full-Text PDF
January 2002

The use of antidepressant drugs in dermatology.

J Eur Acad Dermatol Venereol 2001 Nov;15(6):512-8

Department of Psychiatry, University of Western Ontario, London, Canada.

This paper provides an updated review of the use of antidepressant drugs in dermatology. Some of the psychiatric disorders that are usually comorbid with dermatological disorders and respond to antidepressants include major depressive disorder, obsessive compulsive disorder, body dysmorphic disorder, social phobia and post-traumatic stress disorder usually secondary to trauma and abuse during early life. Cutaneous symptoms may be the feature of a primary psychiatric disorder, e. Read More

View Article and Full-Text PDF
November 2001