Neurotic excoriation presenting as solitary papule: Case report

Abstract

Neurotic excoriation (NE) is a repetitive manipulation of the skin that causes tissue damage. Here, we report on a 56-year-old male, otherwise healthy, who presented with a 1-year history of a recurrent slightly itchy skin lesion on his nose. Skin examination revealed a solitary round 0.5 cm × 0.5 cm pigmented crusted papule on his nose. A skin biopsy was taken, and it showed an epidermal crust with underlying mild inflammatory cell infiltrate in the upper dermis. On the basis of these clinical and pathological findings, the diagnosis of NE was made. The patient was reassured and prescribed Fucidin cream and betamethasone valerate ointment. Behavioral therapy was also initiated.