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Excoriation (Skin-Picking) Disorder: A Comprehensive Review
Alejo Agranatti1, Sergio Ricciardelli2, María Lucía Marchese3
1Médico especialista en Psiquiatría; Jefe del Servicio de Salud Mental Instituto de Investigaciones Médicas Dr. Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires (UBA); Servicio de Psiquiatría Centro de Enseñanza Médica e Investigaciones Clínicas Norberto Quirno (CEMIC); Buenos Aires, Argentina. melanyoppel@gmail.com.
Abstract:
Excoriation disorder (ED), recently recognized as a distinct diagnosis in the DSM-5, is characterized by recurrent compulsive skin picking behaviors that lead to skin lesions and significant emotional, functional, and social impairment. This comprehensive review addresses its pathophysiology, clinical assessment, comorbidities, and treatment, highlighting the importance of a multidisciplinary approach. Advances in neurobiology and pharmacotherapy are discussed, including the use of Selective Serotonin Reuptake Inhibitors, N-acetylcysteine, and naltrexone, as well as the effectiveness of psychotherapeutic interventions such as cognitive-behavioral therapy. ED presents a relevant diagnostic and therapeutic challenge at the intersection of psychiatry and dermatology.