Picking apart the picker: a clinician's guide for management of the patient presenting with excoriations.
Management of patients who "pick" at their skin is often difficult. Etiologies and maintaining factors can be unclear. Significant psychiatric overlay is often present, and the clinician is left with an overwhelming differential diagnosis and a poorly focused treatment plan that can result in suboptimal clinical outcomes. The purpose of this paper is to provide a conceptual framework for the evaluation and treatment of patients presenting with excoriations. Ten diagnostic categories are examined, and specific suggestions for treatment are offered.
Fried
Richard G
RG
Thomas Jefferson University, Philadelphia, Pennsylvania, USA. dermshrink@aol.com
Fried
Sidney
S
D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis; D011602:Psychophysiologic Disorders / Q000175:diagnosis*; D016728:Self-Injurious Behavior / Q000175:diagnosis; D012871:Skin Diseases / Q000523:psychology*; D013001:Somatoform Disorders / Q000175:diagnosis