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Excoriation disorder

Alessandro Minarini, Silvia Ferrari, Martina Galletti, Nina Giambalvo, Daniela Perrone, Giulia Rioli, Gian Maria Galeazzi
N-acetylcysteine (NAC) is widely known for its role as a mucolytic and as an antidote to paracetamol overdose. There is increasing interest in the use of NAC in the treatment of several psychiatric disorders. The rationale for the administration of NAC in psychiatric conditions is based on its role as a precursor to the antioxidant glutathione, and its action as a modulating agent of glutamatergic, dopaminergic, neurotropic and inflammatory pathways. Areas covered: This study reviews the available data regarding the use of NAC in different psychiatric disorders including substance use disorders, autism, obsessive-compulsive spectrum disorders, schizophrenia, depression, bipolar disorder...
October 21, 2016: Expert Opinion on Drug Metabolism & Toxicology
Tian Hao Zhu, Mio Nakamura, Benjamin Farahnik, Michael Abrouk, Jason Reichenberg, Tina Bhutani, John Koo
Individuals with obsessive-compulsive features frequently visit dermatologists for complaints of the skin, hair, or nails, and often progress towards a chronic relapsing course due to the challenge associated with accurate diagnosis and management of their psychiatric symptoms. The current DSM-5 formally recognizes body dysmorphic disorder, trichotillomania, neurotic excoriation, and body focused repetitive behavior disorder as psychodermatological disorders belonging to the category of Obsessive Compulsive and Related Disorders...
September 23, 2016: Journal of Dermatological Treatment
A E Kremer, T Mettang
Chronic pruritus is a symptom of various internal disorders. In contrast to dermatological diseases, pruritus does not present with primary skin alterations in these patients. However, intense scratching may cause secondary skin changes such as abrasion, excoriation, prurigo nodularis, or in rare cases even scaring. The most common internal medicine causes for chronic pruritus are chronic kidney disease, hepatobiliary and hematological disorders as well as adverse drug reactions. Pruritus is less commonly seen in patients with endocrine or metabolic diseases, malabsorption syndromes, infectious diseases and solid tumors...
August 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Christina Gallinat, Nancy J Keuthen, Matthias Backenstrass
At least since the introduction of the official diagnosis Excoriation (Skin-Picking) Disorder in the DSM-5 [1], dermatillomania is an important and growing field of research. Despite the high importance currently a huge lack of German assessment instruments exists. Aim of the present study was the examination of the psychometric properties of the German translation of the Skin Picking Scale-Revised [2]. For this purpose an open online study has been conducted. The analysis of N=2 065 data sets indicated a high internal consistency with Cronbachs Alpha being 0...
June 2016: Psychotherapie, Psychosomatik, Medizinische Psychologie
Robert R Selles, Joseph F McGuire, Brent J Small, Eric A Storch
OBJECTIVE: While individual trials suggest benefit of interventions for excoriation (skin-picking) disorder (ExD), limited systematic evaluation of treatments, or their collective benefit, exists. METHODS: The present study examined the current state of treatments for ExD in a systematic review and meta-analysis and explored potential treatment moderators. Twelve trials were identified for review, including five with a control condition. Of these, nine were eligible to be included in the meta-analysis (three with a control)...
July 2016: General Hospital Psychiatry
M Tampa, Maria Isabela Sârbu, Clara Matei, Daniela E Mihăilă, T D Potecă, Simona-Roxana Georgescu
Acquired perforating disorders are a group of uncommon skin conditions characterized by transepidermal extrusion of altered dermal material, most often associated with diabetes mellitus and chronic kidney failure. Delusional parasitosis is a primary psychiatric disorder in which affected patients have fixed, false beliefs that their skin is infested by parasites, in the absence of any evidence supporting their statements. A 69 year old malepatient addressed the Dermatology Department for a skin eruption consisting of multiple umbilicated keratotic papules with a generalized distribution...
January 2016: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Jon E Grant, Samuel R Chamberlain, Sarah A Redden, Eric W Leppink, Brian L Odlaug, Suck Won Kim
IMPORTANCE: Excoriation (skin-picking) disorder (SPD) is a disabling, underrecognized condition in which individuals repeatedly pick at their skin, leading to noticeable tissue damage. To date, there has been no clearly effective pharmacologic or psychological treatment for SPD. OBJECTIVE: To determine whether N-acetylcysteine, an amino acid that appears to restore extracellular glutamate concentration in the nucleus accumbens, will be more effective than placebo in reducing compulsive picking behavior...
May 1, 2016: JAMA Psychiatry
David Voegeli
Incontinence-associated dermatitis (IAD) is a common skin disorder seen in patients with incontinence. Typically IAD presents as inflammation of the skin surface characterised by redness, and in extreme cases, swelling and blister formation. If untreated this usually rapidly leads to excoriation and skin breakdown, which may subsequently become infected by the skin flora. While this is a common condition encountered in all areas of nursing practice, gaps remain in our understanding of the many contributing factors...
March 10, 2016: British Journal of Nursing: BJN
Marcelo Piquet-Pessôa, Leonardo F Fontenelle
INTRODUCTION: Naltrexone (NTX), a mu-opioid receptor antagonist, has been approved for the treatment of alcoholism and opioid dependence. More recently, however, NTX and a related drug, nalmefene (NMF), have also shown positive results for the treatment of gambling disorders. AREAS COVERED: In this study, we reviewed the trials testing the effect of opioid antagonists (OA) in gambling disorders and in other broadly defined behavioral addictions, including selected DSM-5 disruptive, impulse-control, and conduct disorders, obsessive-compulsive and related disorders, eating disorders, and other conditions not currently recognized by official classification schemes...
2016: Expert Opinion on Pharmacotherapy
Voraluck Phatarakijnirund, Steven Mumm, William H McAlister, Deborah V Novack, Deborah Wenkert, Karen L Clements, Michael P Whyte
Congenital insensitivity to pain (CIP) comprises the rare heritable disorders without peripheral neuropathy that feature inability to feel pain. Fracturing and joint destruction are common complications, but lack detailed studies of mineral and skeletal homeostasis and bone histology. In 2013, discovery of a heterozygous gain-of-function mutation in SCN11A encoding voltage-gated sodium channel 1.9 (Nav1.9) established a distinctive CIP in three unrelated patients who suffered multiple painless fractures, self-inflicted mutilation, chronic diarrhea, and hyperhidrosis...
March 2016: Bone
Ivar Snorrason, Ragnar P Olafsson, David C Houghton, Douglas W Woods, Han-Joo Lee
BACKGROUND AND AIMS: Excoriation (skin-picking) disorder (SPD) is often conceptualized as a behavioral addiction in which aberrant reward processing may play an important role. The current study sought to develop a self-report instrument--the Skin Picking Reward Scale (SPRS)--that measures how strongly skin picking is 'liked' (i.e., the degree of pleasurable feelings while receiving the reward) and 'wanted' (i.e., the degree of the motivation to seek the reward). METHODS: We administered the SPRS to individuals who endorsed excessive skin picking in online surveys and examined the scale's factor structure (Studies 1 and 2)...
December 2015: Journal of Behavioral Addictions
D J Stein, C S Kogan, M Atmaca, N A Fineberg, L F Fontenelle, J E Grant, H Matsunaga, Y C J Reddy, H B Simpson, P H Thomsen, O A van den Heuvel, D Veale, D W Woods, G M Reed
BACKGROUND: To present the rationale for the new Obsessive-Compulsive and Related Disorders (OCRD) grouping in the Mental and Behavioural Disorders chapter of the Eleventh Revision of the World Health Organization's International Classification of Diseases and Related Health Problems (ICD-11), including the conceptualization and essential features of disorders in this grouping. METHODS: Review of the recommendations of the ICD-11 Working Group on the Classification for OCRD...
January 15, 2016: Journal of Affective Disorders
Eric W Leppink, Sarah A Redden, Jon E Grant
OBJECTIVE: Research on trichotillomania (TTM) and excoriation (skin-picking) disorder (SPD) has suggested that impulsivity may be an important cognitive underpinning of the behavior, but many studies have produced mixed results. This analysis assessed impulsivity in TTM and SPD using three measures: the Barratt Impulsiveness Scale (BIS), the Eysenck Impulsiveness Questionnaire (EIQ), and the Stop-Signal Task (SST). METHODS: Two hundred and eighty three subjects with TTM or SPD completed measurement of impulsivity as a part of participation in several research studies...
2016: International Journal of Psychiatry in Clinical Practice
Anthony Ellis, Janet M Risk, Thiviyani Maruthappu, David P Kelsell
Tylosis (hyperkeratosis palmaris et plantaris) is characterised by focal thickening of the skin of the hands and feet and is associated with a very high lifetime risk of developing squamous cell carcinoma of the oesophagus. This risk has been calculated to be 95% at the age of 65 in one large family, however the frequency of the disorder in the general population is not known and is likely to be less than one in 1,000,000. Oesophageal lesions appear as small (2-5 mm), white, polyploid lesions dotted throughout the oesophagus and oral leukokeratosis has also been described...
September 29, 2015: Orphanet Journal of Rare Diseases
Aleksandra Basta-Juzbašić, Zrinka Bukvić Mokos
Primary psychiatric disorders where skin changes appear most frequently include: delusions of parasitosis, body dysmorphic disorder, neurotic excoriations, dermatitis artefacta, and trichotillomania. In all these diseases the primary pathologic condition is of psychiatric nature, and the skin changes are secondary and self-induced. In this review we wanted to present the epidemiology, clinical pictures, and treatment options for these disorders. These patients are more frequently seen in dermatology clinics, as they may be unwilling to acknowledge a psychiatric basis for their psychical symptoms...
2015: Acta Dermatovenerologica Croatica: ADC
Brian L Odlaug, Adam Hampshire, Samuel R Chamberlain, Jon E Grant
BACKGROUND: Excoriation (skin-picking) disorder (SPD) is a relatively common psychiatric condition whose neurobiological basis is unknown. AIMS: To probe the function of fronto-striatal circuitry in SPD. METHOD: Eighteen participants with SPD and 15 matched healthy controls undertook an executive planning task (Tower of London) during functional magnetic resonance imaging (fMRI). Activation during planning was compared between groups using region of interest and whole-brain permutation cluster approaches...
February 2016: British Journal of Psychiatry: the Journal of Mental Science
Elizabeth A Clemmons, Sanjeev Gumber, Elizabeth Strobert, Mollie A Bloomsmith, Sherrie M Jean
A 3.5-y-old, female rhesus macaque (Macaca mulatta) inoculated with SIVmac239 presented 8 mo later for inappetence and facial bruising. Physical examination revealed a superficial skin abrasion below the left eye, bruising below the left brow, and epistaxis of the left nostril. There were no significant findings on CBC, serum chemistry, urinalysis, or radiographs. Differential diagnoses included infectious etiologies, self-injurious behavior, immune-mediated dermatitis, and neoplasia. Lack of response to antibiotic and analgesic therapy and observations of the macaque made it apparent that the skin lesions were self-inflicted...
June 2015: Comparative Medicine
Marco A Grados, Elizabeth B Atkins, Gabriela I Kovacikova, Erin McVicar
Glutamate, an excitatory central nervous system neurotransmitter, is emerging as a potential alternative pharmacological treatment when compared to gamma-aminobutyric acid (GABA)-, dopamine-, and serotonin-modulating treatments for neuropsychiatric conditions. The pathophysiology, animal models, and clinical trials of glutamate modulation are explored in disorders with underlying inhibitory deficits (cognitive, motor, behavioral) including obsessive-compulsive disorder, attention deficit hyperactivity disorder, Tourette syndrome, trichotillomania, excoriation disorder, and nail biting...
2015: Psychology Research and Behavior Management
Izabela A Galdyn, Jeremy Chidester, Mark C Martin
Many mental and emotional disorders have some variations of physical manifestations that are often the first definitive sign of disease. One such disorder is excoriation (skin-picking) disorder, also known as dermatillomania, acne excoriée, neurotic excoriation, or psychogenic excoriation. First identified in the dermatologic literature in 1920, excoriation disorder involves repetitive scratching behavior that sometimes accompanies pruritus and is often associated with depression, anxiety, and obsessive-compulsive disorder...
May 2015: Journal of Craniofacial Surgery
Maja Radić, Darka Hadnadjev
INTRODUCTION: Epidermolysis bullosa is a rare skin disease which could be hereditary or acquired with autoimmune mechanism. Even though it is known that epidermolysis bullosa appears on various mucosa, the esophagus is seldom affected. CASE REPORT: We reported 19-year-old female patient who had been admitted due to dysphagia and odyno- phagia to solid food. Erythematous changes with bullae and excoriations could be found on the hands, feet, elbows and knees. The patient underwent barium swallow which revealed retaining of contrast in the valleculas and piriform recesses, as well as dilatation of meso- and hypopharynx--upper achalasia syndrome...
March 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
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