Addressing body-focused repetitive behaviors in the dermatology practice

Classification of psychodermatological disorders: Proposal of a new international classification

“…Other BFRBs include lip biting/picking, cheek biting/chewing and nail biting/picking. Self‐inflicted skin, hair and nail lesions are then the most common lesions associated with BFRBs 25 …”

“…The clinical characteristics of several BFRBs have been described, as listed below 18,25–30 : Dermatillomania or skin picking disorder (excoriation disorder); Trichotillomania (pulling out the hair, potentially resulting in marked hair loss); Trichoteiromania (physical damage to the hair by rubbing and scratching the scalp); Trichotemnomania (compulsive hair cutting); Trichophagia (rare disorder connected with trichotillomania, characterized by compulsive eating of pulled hairs, with risk of trichobezoars); Onychophagia (nail biting); Onychotemnomania (cutting nails too short leading to traumatization of the nail body/nail fold); Onychotillomania (trauma of the paronychium or continuous manipulation, picking and/or removal of the cuticle/nail); Onychoteiromania (the patient rubs the fingernails); Onychodaknomania (the patient bites on single nails to get a lustful pain); Perionychotillomania (the habit of picking and tearing of the periungual skin); Perionychophagia (the patient bites one's own periungual skin; pieces of skin can be ingested); Rhinotillexomania (nose picking), « Washboard nails » (median nail dystrophy resulting from an habit‐tic deformity, where patients present with a central linear depression surrounded by parallel transverse ridges running from the proximal to the distal end; the nail resembles a washboard; lunulae may become hypertrophic and the proximal matrix may lie exposed); Bidet nails (triangular worn‐down nails of the second–fifth fingers of the dominant hand due to repeated trauma caused by obsessional cleanliness); Pseudo‐knuckle pads (rubbing, chewing, sucking the finger joints); Self‐inflicted cheilitis (compulsive licking); Cheek‐biting and Morsicatio buccarum (cheek‐biting is related to the simple act of biting one's own buccal mucosa, while a particularly vigorous form of cheek‐biting in which pieces are torn from the mucosa is ‘morsicatio buccarum’); Dermatophagia, Dermatodaxia and Dermatothlasia (‘dermatodaxia’ for the compulsion to bite one's own skin without consumption of the skin and dermatophagia when pieces of skin are actually ingested; ‘dermatothlasia’ is characterized by the compulsion to rub or pinch one's own skin to form bruised areas). …”

“…mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (e.g. comparing his or her appearance with that of others) in response to the appearance concerns’ 1,25,34 . Other OCRDs, such as olfactory reference disorder, and also some patients with BDD do not present with visible (secondary) skin lesions; thus, these disorders are examples of the second column (no visible skin lesions).…”

“…Self-inflicted skin, hair and nail lesions are then the most common lesions associated with BFRBs. 25 The clinical characteristics of several BFRBs have been described, as listed below 18,[25][26][27][28][29][30]…”

Body-focused repetitive behaviors: the specifics of the examination and tactics of cognitive behavioral therapy.

“…не в состоянии помочь пациенту справиться с внутренними переживаниями, такими как эмоции и эмоциональная дисрегуляция. Учитывая когнитивно-психофизиологическую модель лечения травмирующего поведения, направленного на тело (cognitive psychophysiological treatment model, CoPs, Roberts, O'Connor, 2015 [8]), делается акцент на метакогнитивные особенности восприятия ситуации, регуляции импульсивности, дезадаптивном перфекционизме, которые часто вызывают напряжение и негативные эмоции, с которыми пациенту трудно совладать.…”