Skin Picking in Prader-Willi Syndrome: Independent of Sensory Processing, Maladaptive Behaviors, and Genetic Subtype

Skin picking, a prevalent and clinically significant issue, can lead to chronic wounds, infections, scarring, and a substantial burden on patients with Prader-Willi syndrome (PWS) and caregivers. However, the psychological and behavioral correlates of skin picking in PWS are poorly understood, and its relationship with sensory processing abnormalities and maladaptive behaviors has not been systematically examined. We conducted a retrospective cross-sectional study involving individuals with genetically confirmed PWS. Skin picking severity was assessed using the Skin Picking Scale (SPS). Sensory processing characteristics and maladaptive behaviors were evaluated using the Japanese versions of the Short Sensory Profile (SSP) and the Aberrant Behavior Checklist (ABC), respectively. Sixty-five individuals with PWS were included. SPS scores showed substantial individual variability. Skin picking severity was not significantly associated with the SSP or ABC subscale scores (all p > 0.05). There were no significant differences in the total SPS scores across the genetic subtypes. Overall, skin picking severity in individuals with PWS was not associated with sensory processing abnormalities, broad maladaptive behaviors, cognitive functioning, or genetic subtypes. These findings suggest that skin picking in patients with PWS may reflect a relatively independent neurobehavioral feature and could inform future research regarding its underlying mechanisms.