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29 July 2013 : Case report  United States Minor outlying Islands

A near fatal case of pathological skin picking

Unknown etiology, Challenging differential diagnosis, Rare disease

Daniel Il-Sun KimABCDEF, Roger Corey GarrisonABCDEF, Gary ThompsonABCDEF

DOI: 10.12659/AJCR.889357

Am J Case Rep 2013; 14:284-287

Abstract

Background: Pathological skin picking (PSP) disorder is characterized by repetitive and compulsive picking of the skin resulting in tissue damage. PSP has been shown to affect 5.4% of a community sample, 4% of college students, and 2% of patients seen in a dermatology clinic. It can be associated with significant disfigurement. The diagnosis requires obtaining a careful history and high clinical suspicion.
Case Report: We report a previously healthy 51-year-old Caucasian female with a history of “acne” who presented with new onset right-sided hemiparesis, mild aphasia and an episode of incontinence. She had memory loss of the prior few days. She also complained of a four-day history of intense headaches and dizziness. CT and MRI of the head showed encephalomalacia involving the left frontal and parietal lobes. Further history from the patient revealed that the patient had been picking at her forehead with a sewing needle and later with a long knitting needle.
Conclusions: PSP is a prevalent disorder, which can have potentially serious health consequences. Besides potential disfigurement and scarring, PSP can have significant morbidity and mortality. Early diagnosis and appropriate treatment by clinicians are essential to prevent potentially fatal consequences.

Keywords: Impulse control disorder, Pathologic skin picking, Skin Picking

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923