11 - Skin Picking: Clinical Aspects

Summary

Skin picking is a common human behavior and often performed as a part of the daily grooming routine. Skin-picking disorder (SPD) is currently classified in Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as an impulse control disorder not otherwise specified along with compulsive impulsive (CI) Internet usage disorder, CI sexual behaviors, and CI shopping. The differential diagnosis of SPD includes medical and psychiatric conditions that cause skin picking directly or that create the sensations, such as pruritus, that lead to skin picking. Self-monitoring techniques can be used to assess the frequency of skin-picking behavior. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) modified for psychogenic excoriation is a ten-question, semistructured, clinician-administered scale that assesses the severity of skin picking in the previous week. Trichotillomania (TTM) is the most common comorbid impulse control disorder in patients with SPD.