Neurotic excoriations in Adult
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 (OCD), depression, anxiety, and substance use disorder. Individuals who use recreational drugs, especially (crystal meth), are prone to neurotic excoriations. Pruritus-inducing drugs such as narcotics, especially , 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.
L98.1 – Factitial dermatitis
247444006 – Excoriation of skin
Differential Diagnosis & Pitfalls
- Other causes of pruritus
- Contact dermatitis
- Irritant contact dermatitis
- Prurigo nodularis
- Dermatitis herpetiformis
- Factitial dermatitis
- Acne excoriée
- Arthropod reaction
- Delusions of parasitosis
- Consider neuropathic injury in a localized area of large excoriation.
- Systemic disease, including neoplasms
- Factitious disorders or medical child abuse
- Burns (see thermal or electrical burn; chemical burns are covered separately, by chemical agent)
- Neuropathic (eg, injection of trigeminal ganglion)
- Lesch-Nyhan syndrome
Drug Reaction Data