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Psychogenic excoriation is self-injurious behaviour characterised by compulsive picking of skin with negligible imperfections.1 Psychogenic parasitosis is an uncommon disorder in which patients have a false, fixed belief of being infested by an organism.2 Individuals may provide false evidence of infestation and frequently induce mechanical trauma to clear the purported organism.2
We present five unique cases of self-induced facial excoriations with psychiatric disease ranging from psychogenic excoriation to psychogenic parasitosis.
Patient 1 presented with a vertical hypertrophic scar involving the forehead (figure 1A). The patient admitted to skin picking. Three years earlier, an abscess from repeated acne pustule manipulation required surgical drainage. The scar was injected with triamcinolone acetonide with improvement.
Competing interests None.
Patient consent Detail has been removed from these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Ethics approval Ethics approval was provided by Washington. The study was approved by Western Institutional Review Board, Olympia, WA.
Provenance and peer review Not commissioned; internally peer reviewed.