Skin-Picking Disorder in Dermatology Settings: A Comprehensive Analysis of Patient Characteristics

BACKGROUND: Skin-picking disorder (SPD) is a psychodermatological condition marked by recurrent, compulsive picking of one's own skin. This study aimed to analyze a large cohort of treatment-seeking SPD patients, focusing on triggers and concomitant diseases through face-to-face evaluations. METHODS: A cross-sectional, multicenter study was conducted. Patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for SPD completed a 23-item semi-structured questionnaire covering demographics, concomitant diseases, triggers, and clinical features. RESULTS: A total of 236 SPD patients were enrolled, and 189 of whom were female. Additional dermatological diseases were identified in 84 participants, and 93 reported a history of primary psychiatric disorder. Mostly cited motivations for engaging in the behavior included itch relief, out of habit, and tension reduction. Picking commonly involved multiple body sites, especially extremities and trunk, with facial picking more frequent in younger patients and those with concomitant dermatological disorders. Over 25% reported more than 20 picking episodes/day, symptoms peaking between 08:00 PM and midnight, often during inactivity. Sensory symptoms included itching and burning. CONCLUSIONS: SPD is a multifactorial disorder with diverse clinical features and triggers. Sensory symptoms, body site involvement, and timing of episodes can guide clinicians in recognizing dermatologic and psychiatric comorbidities. Integrated dermatologic-psychiatric care is key for effective management.