Acne excoriee des jeunes filles
Last Updated: 2020-06-15
Skin picking disease.
Disease in which the tiniest or non-existent impurities of the skin are consciously acted upon by scratching, pinching, pressing or similar manipulations.
According to the diagnostic and statistical manual of mental disorders (DSM-5), acne excoriée belongs to obsessive-compulsive disorders and not, as before, to impulse disorders. Clinically, however, this does not play a major role for the dermatologist. It is much more important to inform the patients about the psychological component and to work together with a psychiatrist or psychologist. Behavioural therapy is a good strategy. Unfortunately, anti-acne topicals (80%) or even largely pointless systemic therapeutics (40%) are still mainly prescribed, and psychiatric care is only organised for 5%.
Almost only women affected. A very high number of women have a mild clinical picture.
It is a special type of neurotic excoriations.
- Scratch excoriated papules and only in the minority acne-typical comedones or papulopustules.
- Blackheads on the nose have no disease value and need not be expressed.
- Medical history.
- Clinical features.
Ask for the insatiable impulse of expression. Patients are aware of this and do not hide it, unlike trichotillomania, for example.
Cut fingernails so that the white edge is no longer visible distally. This can attenuate the first seconds of push-pull behaviour. In addition, it is recommended to keep a diary of the manipulations, which makes the patients aware of the problem.
Usually, improvement occurs only after psychotherapy.
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