Excoriation (skin-picking) disorder
ICD-10 F42.4 is a billable code used to indicate a diagnosis of excoriation (skin-picking) disorder.
Excoriation (skin-picking) disorder is characterized by recurrent skin picking resulting in skin lesions. This condition is classified under obsessive-compulsive and related disorders in the ICD-10. Individuals with this disorder often experience significant distress and impairment in social, occupational, or other important areas of functioning. The behavior may be triggered by anxiety, stress, or boredom, and is often associated with other mental health conditions such as obsessive-compulsive disorder (OCD), anxiety disorders, and post-traumatic stress disorder (PTSD). Patients may pick at their skin to relieve tension or to cope with negative emotions. The disorder can lead to physical complications, including infections, scarring, and significant emotional distress. Treatment typically involves cognitive-behavioral therapy (CBT), habit reversal training, and sometimes pharmacotherapy, particularly when co-occurring anxiety or mood disorders are present. Understanding the interplay between skin-picking behaviors and underlying anxiety disorders is crucial for effective management and treatment.
Comprehensive mental health assessment, including history of skin-picking behavior, associated anxiety symptoms, and treatment history.
Patients presenting with anxiety symptoms who also exhibit skin-picking behaviors, often seeking help for anxiety management.
Consideration of co-morbid conditions such as OCD or PTSD, and the need for a multidisciplinary approach to treatment.
Detailed documentation of skin lesions, infections, and treatment responses, along with psychological evaluations.
Patients with recurrent skin infections or scarring due to skin-picking, requiring both dermatological and psychological intervention.
Collaboration with mental health professionals to address the psychological aspects of skin-picking.
Used for therapy sessions addressing the psychological aspects of skin-picking disorder.
Document the focus of therapy on skin-picking behaviors and associated anxiety.
Psychiatrists should ensure that therapy goals are clearly outlined and progress is documented.
The primary treatment for excoriation disorder includes cognitive-behavioral therapy (CBT), particularly habit reversal training, and may also involve pharmacotherapy for co-occurring anxiety or mood disorders.
