Excoriation (Skin-Picking) Disorder: A Comprehensive Review

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.