Neurotic excoriations in Child
See also in: Hair and ScalpAlerts and Notices
Synopsis
Repetitive skin-picking results in few to several hundred excoriations, scars, and scabs. The lesions typically exhibit delayed healing due to recurrent scratching.
There is a strong relationship between neurotic excoriations and underlying psychiatric disease, most often obsessive-compulsive disorder (OCD), depression, anxiety, and substance use disorder. Individuals who use recreational drugs, especially methamphetamines (crystal meth), are prone to neurotic excoriations. Pruritus-inducing drugs such as narcotics, especially heroin, may result in neurotic excoriations as well.
In children and adults, skin picking is associated with developmental disabilities such as Prader-Willi syndrome. Systemic diseases such as type 2 diabetes mellitus and hepatitis C have also been reported to be associated with neurotic excoriations; however, the significance of this observation remains unclear.
Codes
ICD10CM:L98.1 – Factitial dermatitis
SNOMEDCT:
247444006 – Excoriation of skin
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Other causes of pruritus
- Scabies
- Contact dermatitis
- Irritant contact dermatitis
- Prurigo nodularis
- Dermatitis herpetiformis
- Factitial dermatitis
- Acne excoriée
- Vasculitis
- Impetigo
- Arthropod reaction
- Delusions of parasitosis
- Consider neuropathic injury in a localized area of large excoriation.
- Systemic disease, including neoplasms
- Factitious disorder or Munchausen syndrome by proxy
- Burns (see thermal or electrical burn; chemical burns are covered separately, by chemical agent)
- Abuse
- Neuropathic (eg, injection of trigeminal ganglion)
- Lesch-Nyhan syndrome
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:03/28/2021
Last Updated:04/01/2021
Last Updated:04/01/2021
Neurotic excoriations in Child
See also in: Hair and Scalp