Bridging the Gap between Dermatology and Psychiatry: Prevalence and Treatment of Excoriation Disorders Secondary to Neuropsychiatric Medications

Abstract

(1) Background: The dermatillomania and trichotillomania disorders in this study refer to the subcategory of obsessive-compulsive disorders (OCDs) that are medication-induced. Patients with typical dermatillomania or trichotillomania disorder generally present with other OCD symptoms, although this is not present in the cases of medication-induced skin picking or hair pulling disorders found in the current literature. This paper serves to investigate the prevalence and treatment methods of medication-induced excoriation disorders. (2) Methods: The PubMed database was queried for cases of medication-induced dermatillomania or trichotillomania. The database search resulted in 80 results, 7 of which were full-length case reports in English with acceptable detail on clinical course, yielding nine patients. (3) Results: All patients who discontinued their offending agent had complete resolution of symptoms. Patients who continued their medications saw a resolution of symptoms when treated with an additional medication. Atypical antipsychotics and SSRIs were also noted to have been the offending agent in some cases but a successful treatment in other cases. (4) Conclusion: Patients who discontinued their offending agent or added additional pharmacotherapy for dermatillomania or trichotillomania had the best outcomes. Abnormal serotonin and dopamine levels are thought to be connected to the pathology of this disease.