Arnold et al proposed criteria for the diagnosis of psychogenic excoriation. The diagnostic features can help distinguish the behavior from a response to a medical condition or from another mental disorders. The authors are from the University of Cincinnati.


Skin excoriations include:

(1) scratching

(2) picking

(3) gouging

(4) lancing

(5) digging

(6) rubbing

(7) squeezing


Criteria include all of the following:

(1) maladaptive skin excoriation associated with one or more of the following:

(1a) preoccupation with skin excoriation

(1b) recurrent impulses to excoriate the skin that are viewed as irresistible, intrusive and/or senseless

(1c) recurrent episodes of excoriation resulting in noticeable skin damage

(2) the behavior and its associated preoccupations and impulses cause one or more of the following:

(2a) marked distress

(2b) time consuming

(2c) interfere with social or occupational functioning

(2d) result in infection or other physical comorbidity

(3) cannot be better explained by another mental disorder

(4) not due to a general medical condition



(1) compulsive

(2) impulsive

(3) mixed compulsive-impulsive




associated feelings

trying to avoid increased anxiety, prevent a dreaded event, or as part of an obsession like washing

arousal, pleasure or reduction of tension

awareness while doing


none or minimal

resistance to activity



insight into the seriousness or harmfulness




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