Pickers, Pluckers and Impostors

Abstract

Self-induced mutilation of the skin and its appendages varies from behavioral habits, such as nail biting, to serious factitial injury. Excoriators may be psychologically grouped, and the character of the injury determined by the patient's personality structure. Generally, the self-inflicted injury represents self-punishment and relieves a tension produced by hate, fear or guilt. Differential diagnosis of self-mutilation of the skin and dermatoses is most important.