Cognitive-behavioural therapy for pathological skin picking. Efficacy and procedures

Abstract

Pathological skin picking (PSP), also known as dermatillomania is characterized by excessive and repeated scratching or picking of normal skin or skin with minor surface irregularities. It leads to damage to the skin tissue and significant distress or functional impairment. What is important, this disorder is not caused by basic dermatological disease. Skin picking affects 1.5% of the general population and sometimes begins before the age of ten. Dermatillomania is closely related to trichotillomania (hair pulling disorder, TTM). While pathological skin picking has been documented in the medical literature since the 19th century, it has only recently been included as a distinct entity in psychiatric classification systems. Dermatillomania is not classified in the International Classification of Diseases, 10th Revision. However, in the 11th Revision and in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition it was coded as excoriation disorder (ED), psychogenic excoriation or dermatillomania. Skin picking disorder has been included in the obsessive-compulsive disorder spectrum, given its overlap with conditions such as trichotillomania. One of the clinically effective treatments for dermatillomania is habit reversal training (HRT) and acceptance and commitment therapy (ACT).