Excoriation (skin picking disorder or dermatillomania)

Excoriation is disorder characterized by repeatedly picking one’s own skin to the point
where it forms lesions. It is a chronic skin picking disorder. It is a type of mental disorder
related to obsessive compulsive disorder. Individuals may pick their healthy skin, sometimes
they are not aware of doing so they do it unconsciously. It may typically begin through
adolescence but may also occur through children under 10-year age.

Diagnostic criteria according to DSM V

The DSM-5 diagnostic criteria include:

 Recurrent skin picking that results in skin lesions

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PREVELANCE OF SKIN PICKING (EXCORIATION) DISORDER AMONG
GENERAL POPULATION.

Article 01
Leibovici et al., (2014) conducted a research on the Israeli Jewish and Arab sample
about the prevalence of skin picking disorder. A sample of 2145 adults were selected. The
sample was administered with skin picking disorder questionnaire (SPDQ), also this
questionnaire was used for screening body dysmorphic disorder, alcohol use, depression,
stress, illicit drug use and obsessive-compulsive disorder (OCD) prevalent with skin picking
disorder. The results formulated concluded that the prevalence of the disorder was 5.4% in the
total sample, but it did not have any effect on the gender differences. The results also concluded
that the severity of prevalence of disorders like obsessive compulsive disorder, alcohol use,
depression, stress, illicit drug use and body dysmorphic disorder were much high in the skin
picking disorder positive respondents as compared to the skin picking disorder negative
respondents. It must be kept in mind that cross cultural variations may be found across cultural
variations.

Article 02
Rickets et al., (2017) in a research on Sleeping patterns in adults with trichotillomania
(hair-pulling disorder), excoriation (skin-picking) disorder, and a non-affected comparison
sample concluded that individuals with these disorders have somehow a very disturbed
sleeping pattern. Different samples were selected for each disorder. For trichotillomania a
sample of 259 adults were selected, for excoriation a sample of 182 adults was selected, and
those who were unaffected ranged from 148 adults. The research concluded that the sleep
pattern was distorted for individuals with these disorders as well as they were also more prone
to depression and anxiety. Furthermore, those individuals who were engaged in skin picking
activities during their sleep were also found to be more prone to depression and anxiety as
compared to those who were not engaged into skin picking behaviors during sleep.

Article 03
Turner & Solley (2018) conducted a research on the prevalence of clinically significant
body-focused repetitive behaviors, which caused clinically significance impairments in adults.
These behaviors included skin picking, hair pulling, nail biting and lip biting with the

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prevalence of quality of life. An online survey was conducted with a sample of 1378
participants. About three hundred and eighteen participants reported the presence of body-
focused repetitive behaviors; 85 participants reported nail biting, 88 participants reported lip
biting, 39 participants reported hair pulling and 187 participants reported skin picking. there
was a significant difference between individuals having body focused repetitive behavior as
compared to those who had not. Individuals with body focused repetitive behavior were much
more engaged in higher levels of obsessive compulsive and anxiety disorders. As far as there
was no effect of such behaviors on the quality of life.

Article 04
Sethi et al., (2018) in a research formulated that there was a high prevalence of body
focused repetitive behaviors among medical students of Peshawar. Habit questionnaires was
administered to find out about the common habits. The results concluded that the most common
habit in medical students was lip biting. gender wise it concluded that men were engaged in
activities like punching the wall whereas females were engaged in lip biting; these were the
results for private sectors as for public sector they were more engaged in wall punching, nail
biting, grinding teeth and picking skin like habits.

Article 05
Naqvi et al., (2012) conducted a study on the prevalence of body-focused repetitive
behaviors in three large medical colleges od Karachi. The sample of 210 students were selected
from Karachi’s biggest medical colleges namely The Agha Khan University, Dow Medical
College and Sindh Medical College. Data was collected through habit questionnaire. The
results found concluded that overall 22% of the sample was engaged in body-focused repitive
behaviors in which 9% were included in skin picking behaviors, 13.3% were engaged in hair
pulling behaviors whereas 6.2% were engaged in nail biting behaviors.

Article 06
Akram et al., (2017) in a research on the prevalence and predictors of non-suicidal self-
injury among children with autism spectrum disorder concluded that children with autism
spectrum disorder are actually involved in behaviors like skin picking, hair pulling, skin
rubbing, pinching and itching scabs. The results were concluded by administering an Urdu

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standardized form of questionnaire to the respondents. The sample was selected from five
special schools of Lahore city.

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References:

1. Leibovici, V., Koran, L., Murad, S., Siam, I., Odlaug, B., Mandelkorn, U., Feldman-
Weisz, V., & Keuthen, N. (2014). Excoriation (skin-picking) disorder in adults: a cross-
cultural survey of Israeli Jewish and Arab samples. Comprehensive Psychiatry,
58(April 2015), 102-107.
2. Rickets, E., Snorrason, I., Rozenman, M., Colwell, C., Mccracken, J., & Piacentini, J.
(2017). Sleep functioning in adults with trichotillomania (hair-pulling disorder),
excoriation (skin-picking) disorder, and a non-affected comparison sample. Journal of
Obsessive-Compulsive and Related Disorders, 13(April 2017), 49-57.
3. Solley, K., & Turner, C. (2018). prevalence and correlates of clinically significant body-
focused repititive bahviors in a non-clinical sample. comprehensive psychology,
86(October 2018), 9-18.
4. Khan, s., khan, m., khan, m., sethi, m., & Irfan, m (2018). Frequency of body-focused
repititve behaviours in medical students of Peshawar. Journal of postgraduate medical
institute (Peshawar-pakistan), 32(3).
5. Naqvi, H., Siddiqui, E., & Ahmed, B. (2012). Prevalence of body-focused repetitive
behaviors in three large medical colleges of karachi: a cross-sectional study. BMC
research notes, 5(1), 1.
6. Akram, B., Batool, M., Rafi, Z., & Akram, A. (2017). Prevalence and predictors of non
suicidal self-injury among children with autism spectrum disorder. Pakistan journal of
medical sciences, 33(5)
7. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA,
American Psychiatric Association, 2013.