There has been controversy over the creation of a separate category in the DSM-5 for<unk>  (skin picking) disorder. Two of the main reasons for objecting to the inclusion of<unk>  in the DSM-5 are: that<unk>  may just be a symptom of a different underlying disorder, e.g. OCD or BDD, and<unk>  is merely a bad habit and that by allowing this disorder to obtain its own separate category it would force the DSM to include a wide array of bad habits as separate syndromes, e.g., nail-biting, nose-picking, hair pulling, etc. Stein has argued that<unk>  does qualify as a separate syndrome and should be classified as its own category because: *<unk>  occurs as the primary disorder and not as a subset of a larger disorder. *<unk>  has well-defined clinical features. * There is gathering data on the clinical features and diagnostic criteria for this condition. * There is sufficient data to create this as a separate category for<unk> . * The incidence rate for<unk>  is high within the population. * Diagnostic criteria for the disease have already been proposed. * The classification of<unk>  as a separate condition would lead to better studies and better treatment outcomes. * Classification as a separate condition would lead to more awareness of the disorder and encourage more people to obtain treatment. However, a review of the scientific literature by Jenkins et al. on<unk>  as a separate category in the DSM-5 concluded that such a distinction requires more evidence. Because<unk>  is different from other conditions and disorders that cause picking of the skin, any diagnosis of<unk>  must take into account various other medical conditions as possible causes before diagnosing the patient with<unk> . There are a variety of conditions that cause itching and skin picking including: eczema, psoriasis, diabetes, liver disease, Hodgkin's disease, polycythemia vera, systemic lupus, and Prader–Willi syndrome. In order to better understand<unk> , researchers have developed a variety of scales to categorize skin-picking behavior. These include the Skin-Picking Impact Scale (SPIS), and The Milwaukee Inventory for the Dimensions of Adult Skin-picking. The SPIS was created to measure how skin picking affects the individual socially, behaviorally, and emotionally. As of the release of the fifth Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013, this disorder is classified as its own separate condition under "Obsessive Compulsive and Related Disorders" and is termed<unk>  (skin-picking) disorder". The diagnostic material is as follows: # Repeated picking of the skin, resulting in injuries # Recurring attempts to stop picking while relapses continually occur # Picking causes a substantial amount of distress and substantially impairs everyday functioning # The picking is not caused or cannot be better explained by physiological effects of a substance or a medical disorder # The picking is not more accurately attributed to another mental disorder Classification Since the DSM-5 (2013),<unk>  is classified as "L98.1<unk>  (skin-picking) disorder" in ICD-10; and is no longer classified in "Impulse control disorder" (f63).<unk>  is defined as "repetitive and compulsive picking of skin which results in tissue damage". Its most official name had been "dermatillomania" for some time. As of the release of the DSM-5 in May 2013,<unk>  is classified as its own separate condition under "Obsessive Compulsive and Related Disorders" and is termed<unk>  (skin-picking) disorder". Similarities with other conditions The inability to control the urge to pick is similar to the urge to compulsively pull one's own hair, i.e., trichotillomania. Researchers have noted the following similarities between trichotillomania and<unk> : the symptoms are ritualistic but there are no preceding obsessions; there are similar triggers for the compulsive actions; both conditions appear to play a role in modifying the arousal level of the subject; and the age of onset for both conditions is similar. There is also a high level of comorbidity between those that have trichotillomania and those that have<unk> . A notable difference between these conditions is that skin picking seems to be dominated by females whereas trichotillomania is more evenly distributed across genders. Research has also suggested that<unk>  may be thought of as a type of obsessive compulsive disorder (OCD).<unk>  and OCD are similar in that they both involve "repetitive engagement in behaviors with diminished control" and also both generally decrease anxiety. Nevertheless, Odlaug and Grant have suggested that<unk>  is more akin to substance use disorder than OCD. They argue that<unk>  differs from OCD in the following fundamental ways: * There is a much greater share of females with<unk> . *<unk>  may be inherently pleasurable whereas OCD is not. * The treatments that are generally effective for patients with OCD (i. e., SSRIs and exposure therapy) are not as successful in patients with<unk> . * Unlike OCD, picking the skin is rarely driven by obsessive thoughts. Odlaug and Grant have recognized the following similarities between individuals with dermatillomania and patients with addictions: * Compulsion to engage in the negative behavior despite knowledge of the harm. * Lack of control over the problematic behavior. * Strong urge to engage in the behavior before engagement. * Feeling of pleasure while engaging in the behavior or a feeling of relief or reduced anxiety after engaging in the behavior. One study that supported the addiction theory of picking found that 79% of patients with<unk>  reported a pleasurable feeling when picking. Odlaug and Grant also argue that dermatillomania could have several different psychological causes, which would explain why some patients seem more likely to have symptoms of OCD, and others, of an addiction. They suggest that treating certain cases of<unk>  as an addiction may yield more success than treating them as a form of OCD.
Excoriation disorder
Trichotillomania
Necrospermia
Papulosquamous disorder
Adermatoglyphia
Oral galvanism
Pellagra
Trichostasis spinulosa