Neurotic Excoriations With Report of Cases

Abstract

There is considerable literature in dermatology on the subject of self-inflicted lesions of the skin. The cases fall into two groups: Group 1.\p=m-\Cases in which self-inflicted lesions are produced surreptitiously. Group 2.\p=m-\Casesin which the lesions are self-inflicted through a nervous impulse, but without deception being an essential factor in the practice. The familiar types of dermatitis factitia constitute the first group of cases, and they need not detain us. The second group is sharply distinguished from the first by the fact that deception is not an essential feature. These patients know the part they play in the production of their lesions, or it can easily be determined from their histories. They readily admit that the lesions are self-inflicted, but they have a neurotic impulse which is quite or almost irresistible to continue in this practice. These cases have apparently had little recognition, and the dermatologic literature concerning them is scant. Adamson1 in the British Journal of Dermatology, calls attention to the subject and summarizes it. THREE TYPES OF SELF-INFLICTED LESIONS These cases have been described in the literature under many names. * Read before the Forty-Second Annual Meeting of the American Dermatological Association, held at Atlantic City. N.

Psychiatric and Psychometric Issues in Acné excoriée

“…This stress-dependent urge to manipulate the skin has been considered as a kind of neurotic behavior, which led to con ceptualize acné excoriée as a neurotic excoria tion [2,[10][11][12][13]. In line with this assumption, significantly elevated scores of Conversion Hysteria were found in the present study, indicating an increased susceptibility to neu rotic symptoms.…”

“…Several authors consid ered acné excoriée as a factitious disorder (dermatitis artefacta) [4][5][6][7][8][9], while others re garded acne excoriée as a neurotic excoriation [10][11][12][13]. In particular, the role of phobic or obsessive-compulsive mechanisms have been discussed for the development of acne excoriée [3,14,15].…”

“…At present, studies considering psychiatric aspects of acné excoriée are com paratively rare and those available are mostly of anecdotal nature [3,5,16,17]. Further more, most authors refer to psychodynamically oriented psychological constructs that limit any generalizable conclusions [2,[5][6][7][8][9][10][11][12][13]17], Thus, the nosological position of acné exco riée as a distinct diagnostic entity -as sup posed by Albrecht and Schônfelder [16] -still remains to be established. The present pilot study was therefore designed to determine the most relevant psychopathological and psycho metric characteristics in acné excoriée pa tients.…”

Skin Picking in German Students

“…Severe SP causes noticeable tissue damage, can be time-consuming, and often causes significant distress or impairment in physical, social, or occupational functioning. The severity of functional impairment has been documented in reports of individuals spending several hours daily digging deep into the skin (Benjamin, & Buot-Smith, 1993;Pusey, & Senear, 1920), sometimes with even life-threatening severity (O'Sullivan, Phillips, Keuthen, & Wilhelm, 1998). To be classified as primary severe SP, the behavior should not be accounted for by another psychiatric illness, such as a delusion of parasitosis, dementia, or mental retardation (e.g., Prader Willi Syndrome).…”

Neurotic Excoriations ‐ A Quantitative Approach to the Effect of Treatment

“…A variety of treatments have been suggested for this condition including simple psychotherapy (Klauder, 1925;Calnan and O'Neill, 1952), dynamically orientated psychotherapy (Seitz, OF CLINICAL PRACTICE 1953), reassurance and su ppon (Cormia, 1951), appeals to reason (Pusey and Senear, 1920), encouragement towards self-control (Adamson, 1915) and shock therapy (Michelson, 1945). Strangely there have been few reports on the effect of psychotropic drugs.…”