Sertraline in the treatment of neurotic excoriation
and related disorders.
Neurotic excoriation (psychogenic excoriation, skin picking, or dermatillomania) (NE) is a psychodermatological disease characterized by an irresistible urge to scratch and pick healthy skin, which leads to self-inflicted lesions (4).
2l * NE age of onset (years) (Mean [+ or -] SD) Duration of disease (months) (Mean [+ or -] SD) SD: standard deviation; NE: neurotic excoriation Table 2.
Within this classification are psychogenic skin excoriation, such as neurotic excoriation
, and acne excoriee.
The authors referred to the high proportion of patients in both groups taking psychotropic medications in the study, a finding that was "even more striking" since the study excluded patients who had conditions known to be associated with psychopathology, such as vitiligo, psoriasis, and neurotic excoriations
Prurigo nodules are cutaneous lesions often produced by repetitive scratching--hence the nickname "picker's nodules"--which may occur as sequelae of chronic pruritus or neurotic excoriations.
The differential diagnosis for PN includes dermatitis herpetiformis, scabies, lichen simplex chronicus, hypertrophic lichen planus, perforating disorders, atopic dermatitis, allergic contact dermatitis, neurotic excoriations, and multiple keratoacanthomas.
are also a condition in which the patients induce cutaneous lesions through repetitive, compulsive excoriations of their skin.
Cognitive-behavioral techniques that address dysfunctional cognitions (thought patterns) or behaviors (actions) can be useful for skin disorders with a significant psychosomatic or behavioral component, such as the picking component of acne excoriee, scratching in atopic dermatitis, habits such as lip licking or biting, hyperhidrosis, lichen simplex chronicus, neurotic excoriations
, onychotillomania, trichotillomania, and psychosomatic triggering or exacerbation of urticaria.
The patients most likely to present to a dermatologist are those with delusions of parasitosis, factitial dermatitis, neurotic excoriations
, trichotillomania, and borderline personality disorder.
The differential diagnosis includes psychogenic parasitosis, factitial dermatitis, and neurotic excoriations