Self-Inflicted Lesions in Dermatology: A Management and Therapeutic
Approach – A Position Paper From the European Society for Dermatology and Psychiatry
Lucía Tomas-Aragones, Silla M. Consoli, Sylvie G. Consoli, Francoise Poot, Klaus-Michael Taube, M. Dennis Linder, Gregor B.E. Jemec, Jacek C. Szepietowski, John de Korte, Andrey N. Lvov, Uwe Gieler
DOI: 10.2340/00015555-2522
Abstract
The classification of self-inflicted skin lesions proposed by the European Society for Dermatology and Psychiatry
(ESDaP) group generated questions with regard to specific treatments that could be recommended for such cases. The therapeutic guidelines in the current paper integrate new psychotherapies and psychotropic drugs without forgetting the most important relational characteristics required for dealing with people with these disorders. The management of self-inflicted skin lesions necessitates empathy and a doctor–patient relationship based on trust and confidence. Cognitive behavioural therapy and/or psychodynamic and psychoanalytic psychotherapy (alone, or combined with the careful use of psychotropic drugs) seem to achieve the best results in the most difficult cases. Relatively new therapeutic techniques, such as habit reversal and mentalization-based psychotherapy, may be beneficial in the treatment of skin picking syndromes
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