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Neurotic excoriations in Adult
See also in: Hair and Scalp
Other Resources UpToDate PubMed

Neurotic excoriations in Adult

See also in: Hair and Scalp
Contributors: Haya Raef MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Neurotic excoriations is a skin condition arising from compulsive or habitual skin scratching or picking in the absence of underlying pathology. Unlike patients with dermatitis artefacta, those with neurotic excoriations will usually admit their involvement in creating the lesions. The disorder is predominantly seen in middle-aged females but can be seen in patients of almost any age. The continued scratching can lead to the itch-scratch-rash cycle, further perpetuating the condition.

Repetitive skin-picking results in few to several hundred excoriations, scars, and scabs. The lesions typically exhibit delayed healing due to recurrent scratching.

There is a strong relationship between neurotic excoriations and underlying psychiatric disease, most often obsessive-compulsive disorder (OCD), depression, anxiety, and substance use disorder. Individuals who use recreational drugs, especially methamphetamines (crystal meth), are prone to neurotic excoriations. Pruritus-inducing drugs such as narcotics, especially heroin, may result in neurotic excoriations as well.

In children and adults, skin picking is associated with developmental disabilities such as Prader-Willi syndrome. Systemic diseases such as type 2 diabetes mellitus and hepatitis C have also been reported to be associated with neurotic excoriations; however, the significance of this observation remains unclear.

Codes

ICD10CM:
L98.1 – Factitial dermatitis

SNOMEDCT:
247444006 – Excoriation of skin

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:03/28/2021
Last Updated:04/01/2021
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Neurotic excoriations in Adult
See also in: Hair and Scalp
Neurotic excoriations : Linear configuration, Non-healing skin lesions, Substance abuse, Pruritus, Skin erosions, Atrophic scars, Excoriations
Clinical image of Neurotic excoriations
A close-up of linear, crusted excoriations.
Copyright © 2021 VisualDx®. All rights reserved.