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Related Experiment Video

Updated: Dec 25, 2025

Isolating Hair Follicle Stem Cells and Epidermal Keratinocytes from Dorsal Mouse Skin

Isolating Hair Follicle Stem Cells and Epidermal Keratinocytes from Dorsal Mouse Skin

Published on: April 29, 2016

Recovery from pathological skin picking and dermatodaxia using a revised decoupling protocol.

Steffen Moritz¹, Michael Rufer², Stella Schmotz¹

¹Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Journal of Cosmetic Dermatology

|April 1, 2020

Summary

A revised decoupling protocol effectively treated pathological skin picking (PSP) and dermatodaxia in a refractory case. This technique shows promise for these underdiagnosed body-focused repetitive disorders.

Keywords:

decoupling dermatodaxia skin injury skin picking wolf-biting

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Last Updated: Dec 25, 2025

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Area of Science:

Psychiatry
Behavioral Science

Background:

Pathological skin picking (PSP) and dermatodaxia are body-focused repetitive disorders.
Habit reversal training (HRT) is a primary treatment for these conditions.

Observation:

A 50-year-old man with lifelong PSP and dermatodaxia remained treatment-refractory to conventional decoupling and HRT.
Previous attempts to stop nail-biting using decoupling were partially successful.

Findings:

A revised decoupling protocol led to the complete cessation of PSP and dermatodaxia.
Skin Picking Scale Revised (SPS-R) scores decreased from 15 to 0.

Implications:

The revised decoupling protocol offers a promising, user-friendly approach for underdiagnosed PSP and dermatodaxia.
Further randomized controlled trials are necessary to validate the efficacy of this revised protocol.