Major considerations in neurotic skin excoriations and psychiatric disorders: a systematic review

Abstract

Introduction: Among psychiatric dermatoses, neurotic excoriation is characterized by the patient's confession of causing lesions on the skin itself, without presenting a basic dermatological disease. The theme has been gaining prominence since the incorporation of the diagnosis in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5, APA 2014). Objective: The present study addressed the main clinical findings in research studies on neurotic excoriation, in addition to valuing the importance of psychological aspects in etiopathogenesis. Methods: The research and development of the work were carried out from June to July 2024 in the Scopus, PubMed, Science Direct, and Scielo databases, using the main scientific articles on nutrigenomics, and following the PRISMA rules. The quality of the studies was based on the GRADE and AMSTAR-2 instruments, and the risk of bias by the Cochrane instrument (Funnel Plot). Results and Conclusion: 18 studies were included out of a total of 115. According to the GRADE instrument, most studies presented homogeneity in their results, with X2=89.5%>50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 25 studies that did not meet the GRADE and AMSTAR-2 criteria. it was found that the subject has been scarcely addressed in the literature since not all cases are diagnosed and this pathology has more than one denomination (excoriation disorder, pathological palpation of the skin, neurodermatitis, dermatothilomania, and psychogenic excoriation). Therefore, the present study addressed the main clinical findings in research studies, through a systematic review, on neurotic excoriation, in addition to valuing the importance of psychological aspects in etiopathogenesis.