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Skin picking disorder in the elderly- What is the available evidence?

Published online by Cambridge University Press:  27 August 2024

O. Vasiliu ,
A. G. Mangalagiu ,
B. M. Petrescu ,
C. A. Candea ,
C. Tudor ,
D. Ungureanu ,
M. Miclos ,
C. Florescu ,
A. I. Draghici  and
R. E. Bratu-Bizic
...Show all authors
O. Vasiliu*
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
A. G. Mangalagiu
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
B. M. Petrescu
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
C. A. Candea
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
C. Tudor
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
D. Ungureanu
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
M. Miclos
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
C. Florescu
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
A. I. Draghici
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
R. E. Bratu-Bizic
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
M. Dobre
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
A. F. Fainarea
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
M. C. Patrascu
Affiliation:
Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
*
*Corresponding author.

Abstract

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Introduction

Excoriation disorder (ExD) is a pathology recognized by DSM-5, and it is considered a part of the obsessive-compulsive spectrum. ExD is associated with a high rate of psychiatric comorbidity (e.g., depression, ADHD, substance use disorders, etc.).

Objectives

The main objective of this review was to explore the available evidence to support the diagnosis and treatment of skin picking in elderly population.

Methods

A literature review of the available sources reporting on ExD in elderly patients, realized by searching three electronic databases (PubMed, Cochrane, Clarivate/Web of Science) but also the grey literature. All papers published between January 1990 and July 2023, including the terms “excoriation disorder”, “compulsive skin picking”, “dermatillomania” and “elderly” or “old-age patients” were reviewed.

Results

The information about ExD was extracted almost exclusively from reports on elderly patients with neurocognitive disorders. Tactile hallucinations, delusions of contamination, social isolation and focusing on own bodily sensations, and organic causes- dehydration, allergies, renal insufficiency, hepatic and pancreatic diseases, as well as toxic causes- e.g., adverse events of certain drugs should be investigated in elderly patients exhibiting signs of ExD. A differential diagnosis is very important in this population in order to find the most adequate treatment. Behavioral treatments, serotonergic antidepressants, and glutamatergic modulators have been explored in patients with ExD, although specific trials for elderly patients with this disorder are still lacking. However, case reports support the utility of several serotonergic antidepressants in the elderly.

Conclusions

ExD is a less explored disorder in the elderly, where an extensive differential diagnosis and screening for somatic/psychiatric comorbidities are needed. Trials exploring the potential treatments for ExD in old-age patients are also required for evidence-based case management.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S632 - S633
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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