Exploring the Interdisciplinary Roles of Dermatologists and Psychiatrists in the Management of Excoriation (Skin-picking) Disorder
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Abstract
ABSTRACT:
Excoriation disorder is a mental health disorder characterized by excessive picking of one’s skin resulting in clinically significant functional impairment. Diagnosing this condition has been historically challenging due to the varied associated behaviours and lack of inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM). As dermatologists and psychiatrists are the specialists most likely to encounter these individuals, this article discusses the new DSM-5 criteria and outlines the approaches and treatment options for these specialists to optimally manage patients with excoriation disorder.
RÉSUMÉ:
L’acné excoriée est un trouble de santé mentale caractérisé par le grattage et l’arrachage excessif de la peau qui mènent à une dysfonction clinique significative. Le diagnostic précis de cette condition demeure un défi lorsqu’on tient compte de la variété des comportements qui y sont associés et le manque d’inclusion des caractéristiques de ce problème de santé dans le DSM(Manuel diagnostique et statistique des troubles mentaux). Étant donné que les dermatologues et les psychiatres sont les spécialistes les plus susceptibles de traiter ces problèmes de santé mentale, cet article présente les nouveaux critères du DSM-5 et décrit les grandes lignes cliniques, les approches nécessaires et les options de traitement afin que ces spécialistes puissent intervenir auprès des patients avec l’acné excoriée de façon optimale.
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References
2. Vythilingum B, Stein DJ. Obsessive-compulsive disorders and dermatologic disease. Dermatol Clin. 2005;23:675-680.
3. Van Ameringen M, Patterson B, Simpson W. DSM-5 obsessive-compulsive and related disorders: clinical implications of new criteria. Depress Anxiety. 2014;31:487–493.
4. Grant JE, Odlaug BL. Update on pathological skin picking. Curr Psychiatry Rep. 2009;11:283–288.
5. Gupta MA, Gupta AK. Current concepts in psychodermatology. Curr Psychiatry Rep. 2014;16:449.
6. Arnold LM, Auchenbach MB, McElroy SL. Psychogenic excoriation: clinical features, proposed diagnostic criteria, epidemiology and approach to treatment. CNS Drugs. 2001;15(5):351-359.
7. Griesemer RD. Emotionally triggered disease in a dermatologic practice. Psychiatr Ann. 1978;8:407–412.
8. Keuthen NJ, Deckersbach T, Wilhelm S, et al. Repetitive skin-picking in a student population and comparison with a sample of self-injurious skin-pickers. Psychosomatics. 2000;41:210–215.
9. Hayes SL, Storch EA, Berlanga L. Skin picking behaviors: an examination of the prevalence and severity in a com- munity sample. J Anxiety Disord. 2009;23:314–319.
10. Arnold LM, McElroy SL, Mutasim DF, et al. Characteristics of 34 adults with psychogenic excoriation. J Clin Psychiatry. 1998;59:509–514.
11. Odlaug BL, Grant JE. Childhood-onset pathologic skin picking: clinical characteristics and psychiatric comorbidity. Compr Psychiatry. 2007;48:388–393.
12. American Psychiatric Association. Obsessive compulsive and related disorders. In: Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.
13. Wilhelm S, Keuthen NJ, Deckersbach T, et al. Self-injurious skin picking: clinical characteristics and comorbidity. J Clin Psychiatry. 1999;60:454–459.
14. Fried RG, Fried S. Picking apart the picker: a clinician’s guide for management of the patient presenting with excoriations. Cutis. 2003;71:291-8.
15. Fried RG. Evaluation and treatment of “psychogenic” pruritus and self-excoriation. J Am Acad Dermatol. 1994;30:993-9.
16. Gupta MA, Gupta AK. Psychodermatology: an update. J Am Acad Dermatol. 1996;34:1030-46.
17. Grant JE, Odlaug BL, Chamberlain SR, et al. Skin picking disorder. Am J Psychiatry. 2012;169:1143–1149.
18. Simeon D, Stein DJ, Gross S, et al. A double-blind trial of fluoxetine in pathologic skin picking. J Clin Psychiatry. 1997;58:341–347.
19. Bloch MR, Elliott M, Thompson H, et al. Fluoxetine in pathological skin-picking: open-label and double-blind results. Psychosomatics. 2001;42:314–319.
20. Arnold LM, Mutasim DF, Dwight MM, et al. An open clinical trial of fluvoxamine treatment of psychogenic excoriation. J Clin Psychopharmacol. 1999;19:15–18.
21. Kalivas J, Kalivas L, Gilman D, et al. Sertraline in the treatment of neurotic excoriations and related disorders. Arch Dermatol. 1996;132:589–590.
22. Keuthen NJ, Jameson M, Loh R, et al. Open-label escitalopram treatment for pathological gambling. Int Clin Psychopharmacol. 2007;22:268–274.
23. Grant JE, Odlaug BL, Kim SW. Lamotrigine treatment of pathologic skin picking: an open-label study. J Clin Psychiatry. 2007;68:1384–1391.
24. Teng EJ, Woods DW, Twohig MP. Habit reversal as a treatment for chronic skin picking: a pilot investigation. Behav Modif. 2006;30:411–422.