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Excoriation Disorder Differential Diagnoses

  • Author: Noah S Scheinfeld, JD, MD, FAAD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Jan 26, 2016
 
 

Diagnostic Considerations

In addition to the conditions listed in the differential diagnosis, other problems (both psychiatric and medical) to be considered include the following:

  • Anxiety
  • Body dysmorphic disorder
  • Borderline personality disorder
  • Carcinoid
  • Cocaine use
  • Delirium
  • Depression
  • Dermatitis artefacta
  • Diabetes mellitus
  • Hepatic disease
  • Hyperthyroidism
  • Hypothyroidism
  • Internal cancers
  • Intestinal parasitosis
  • Iron deficiency anemia
  • Lymphoma
  • Medication reactions
  • Multiple sclerosis
  • Obsessive-compulsive disorder
  • Opiate use
  • Polycythemia vera
  • Pregnancy
  • Renal disease
  • Somatoform disorders
  • Tic disorder
  • Trichotillomania
  • Trigeminal trophic syndrome
  • Uremia
  • Urticaria
  • Xerosis

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Noah S Scheinfeld, JD, MD, FAAD Assistant Clinical Professor, Department of Dermatology, Weil Cornell Medical College; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, New York Eye and Ear Infirmary; Assistant Attending Dermatologist, New York Presbyterian Hospital; Assistant Attending Dermatologist, Lenox Hill Hospital, North Shore-LIJ Health System; Private Practice

Noah S Scheinfeld, JD, MD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Abbvie<br/>Received income in an amount equal to or greater than $250 from: Optigenex<br/>Received salary from Optigenex for employment.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

David F Butler, MD Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology

Disclosure: Lippincott Williams Wilkins Royalty Textbook editor

Shyam Verma, MBBS, DVD, FAAD Clinical Associate Professor, Department of Dermatology, University of Virginia; Adjunct Associate Professor, Department of Dermatology, State University of New York at Stonybrook, Adjunct Associate Professor, Department of Dermatology, University of Pennsylvania

Shyam Verma, MBBS, DVD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References
  1. Jafferany M, Vander Stoep A, Dumitrescu A, Hornung RL. 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. [Medline].

  2. Brodin MB. Neurotic excoriations. J Am Acad Dermatol. 2010 Aug. 2:341-2. [Medline].

  3. Leibovici V, Murad S, Cooper-Kazaz R, Tetro T, Keuthen NJ, Hadayer N, et al. Excoriation (skin picking) disorder in Israeli University students: prevalence and associated mental health correlates. Gen Hosp Psychiatry. 2014 Nov-Dec. 36(6):686-9. [Medline].

  4. Snorrason I, Olafsson RP, Houghton DC, Woods DW, Lee HJ. 'Wanting' and 'liking' skin picking: A validation of the Skin Picking Reward Scale. J Behav Addict. 2015 Dec. 4(4):250-60. [Medline].

  5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, Va: American Psychiatric Association; 2013. 254-7.

  6. Shah KN, Fried RG. Factitial dermatoses in children. Curr Opin Pediatr. 2006 Aug. 18(4):403-9. [Medline].

  7. Gieler U, Consoli SG, Tomás-Aragones L, et al. 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 10. 93(1):4-12. [Medline].

  8. Koblenzer CS. Neurotic excoriations and dermatitis artefacta. Dermatol Clin. 1996 Jul. 14(3):447-55. [Medline].

  9. Andreoli E, Finore ED, Provini A, Paradisi M. [Self-inflicted dermatitis: a case in pediatric age]. Minerva Pediatr. 2008 Jun. 60(3):355-9. [Medline].

  10. Cyr PR, Dreher GK. Neurotic excoriations. Am Fam Physician. 2001 Dec 15. 64(12):1981-4. [Medline].

  11. Anetakis Poulos G, Alghothani L, Bendo S, Zirwas MJ. Neurotic excoriations: a diagnosis of exclusion. J Clin Aesthet Dermatol. 2012 Feb. 5:3-4. [Medline].

  12. Misery L, Chastaing M, Touboul S, et al. Psychogenic Skin Excoriations: Diagnostic Criteria, Semiological Analysis and Psychiatric Profiles. Acta Derm Venereol. 2012 Mar. [Medline].

  13. Setyadi HG, Cohen PR, Schulze KE, et al. Trigeminal trophic syndrome. South Med J. 2007 Jan. 100(1):43-8. [Medline].

  14. Odlaug BL, Hampshire A, Chamberlain SR, Grant JE. Abnormal brain activation in excoriation (skin-picking) disorder: evidence from an executive planning fMRI study. Br J Psychiatry. 2015 Jul 9. [Medline].

  15. Paley K, Prevost N, English JC 3rd. Unna sleeve for neurotic excoriations. Cutis. 2010 Mar. 85(3):149-52. [Medline].

  16. Krishnan A, Koo J. Psyche, opioids, and itch: therapeutic consequences. Dermatol Ther. 2005 Jul-Aug. 18(4):314-22. [Medline].

  17. Grados MA, Atkins EB, Kovacikova GI, McVicar E. A selective review of glutamate pharmacological therapy in obsessive-compulsive and related disorders. Psychol Res Behav Manag. 2015 Apr 28. 8:115-31. [Medline].

  18. Fellner MJ, Majeed MH. Tales of bugs, delusions of parasitosis, and what to do. Clin Dermatol. 2009 Jan-Feb. 27(1):135-8. [Medline].

  19. Gupta MA, Gupta AK. Fluoxetine is an effective treatment for neurotic excoriations: case report. Cutis. 1993 May. 51(5):386-7. [Medline].

  20. Gupta MA, Gupta AK. Olanzapine may be an effective adjunctive therapy in the management of acne excoriée: a case report. J Cutan Med Surg. 2001 Jan-Feb. 5(1):25-7. [Medline].

  21. Biondi M, Arcangeli T, Petrucci RM. Paroxetine in a case of psychogenic pruritus and neurotic excoriations. Psychother Psychosom. 2000 May-Jun. 69(3):165-6. [Medline].

  22. Gupta MA. 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. [Medline].

  23. Dereli T, Karaca N, Inanir I, Oztürk G. Gabapentin for the treatment of recalcitrant chronic prurigo nodularis. Eur J Dermatol. 2008 Jan-Feb. 18(1):85-6. [Medline].

  24. Shenefelt PD. Using hypnosis to facilitate resolution of psychogenic excoriations in acne excoriée. Am J Clin Hypn. 2004 Jan. 46(3):239-45. [Medline].

  25. Fried RG. Nonpharmacologic treatments in psychodermatology. Dermatol Clin. 2002 Jan. 20(1):177-85. [Medline].

  26. Turner GA, Sutton S, Sharma A. Augmentation of Venlafaxine with Aripiprazole in a Case of Treatment-resistant Excoriation Disorder. Innov Clin Neurosci. 2014 Jan. 11(1-2):29-31. [Medline].

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A picker's nodules with no crust and a scarred appearance.
A picker's nodule with crusted lesions.
 
 
 
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