Psychogenic Skin Excoriations: Diagnostic Criteria, Semiological Analysis and Psychiatric Profiles
Laurent Misery, Myriam Chastaing, Sylviane Touboul, Valérie Callot, Martine Schollhammer, Paul Young, Nathalie Feton-Danou, Sabine Dutray, French Psychodermatology Group
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. Common or specific characteristics were identified according to type of case. The majority of patients associated first excoriations with personal problems. Four patients reported abuse in childhood or adolescence. This study confirms that skin picking is an impulsive reaction and does not belong to the obsessive-compulsive disorders: impulsivity is defined by ineffective or failing control resulting in uninhibited behaviour.