What causes excoriation (skin-picking) disorder?

Updated: Jul 10, 2018
  • Author: Roxanne Graham, MD; Chief Editor: Dirk M Elston, MD  more...
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Neurotic excoriations are due either to an underlying psychopathology or to the formation of habit. Accordingly, their pathophysiology is poorly understood.

Shah and Fried found neurotic excoriations to be among the most common factitious skin diseases in children; they further noted that factitious skin disease is less common in children and can often be linked to comorbid psychiatric diagnoses or a psychosocial stressor that can be identified. [5] Subsequently, a task force of dermatologists, psychiatrists, and psychologists worked to place neurotic excoriations in their proper category in dermatology and psychology, finding that mental disorders with pathologic activities could underline the disease. [6]

The causes of neurotic excoriations are manifold and can relate to picking as a means of resolving stress or, as noted, to some underlying psychopathology. [7] Some believe neurotic excoriations to be a physical manifestation of obsessive-compulsive disorder (OCD).

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