Epidemiology and comorbidities of excoriation disorder: A retrospective case-control study

Christina Kwon, Nishadh Sutaria, Raveena Khanna, Erik Almazan, Kyle Williams, Noori Kim, Sarina Elmariah, Shawn G. Kwatra

Research output: Contribution to journalArticlepeer-review


Excoriation disorder is a psychocutaneous disorder characterized by repetitive skin-picking and associated with significant morbidity. Currently, epidemiological data in patients with excoriation disorder are lacking so we sought to characterize common patient demographics and comorbidities. We conducted a retrospective case-control study comparing 250 patients with excoriation disorder with 250 age-, race-and sex-matched controls identified between 2007 and 2019 at a single tertiary care center. We found that the majority of excoriation disorder patients were female (76%), Caucasian (82%) and unmarried (62%), with a mean age of 49 years. Compared to the matched controls, patients with excoriation disorder had increased odds of several psychiatric illnesses, including obsessive compulsive disorder (odds ratio (OR) 28.48, 95% confidence interval (CI): 1.68, 481.75), substance use disorder (OR 24.33, 95% CI: 5.81, 101.77), post-traumatic stress disorder (OR 8.23, 95% CI: 2.24, 129.40), depression (OR 8.19, 95% CI: 4.86, 13.80), bipolar disorder (OR 7.55, 95% CI: 2.22, 25.65), attention-deficit/hyperactivity disorder (OR 5.63, 95% CI: 1.62, 19.57), and anxiety (OR 5.01, 95% CI: 2.92, 8.62). Only a minority (42%) of patients were given psychiatry referrals and of those referred, a majority (64%) did not follow-up with psychiatry. The outcomes were also generally unfavorable as only 21% of patients experienced a resolution or improvement in their symptoms. This highlights the need for a multidisciplinary approach to manage patients with excoriation disorder, involving both dermatologists and psychiatrists.

Original languageEnglish (US)
Article number2703
Pages (from-to)1-9
Number of pages9
JournalJournal of Clinical Medicine
Issue number9
StatePublished - Sep 2020


  • Comorbidities
  • Epidemiology
  • Excoriation disorder
  • Itch
  • Pruritus
  • Skin-picking

ASJC Scopus subject areas

  • General Medicine


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