Patients with Tourette syndrome (TS) and obsessive-compulsive disorder (OCD) may present to a dermatologist because of skin lesions resulting from scratching, picking, and other self-injurious behaviors.1- 3 To provide optimal therapy, it is critical that the dermatologist recognizes that excoriations, dermatitis, acne, and other skin disorders may be manifestations of underlying neuropsychiatric conditions, such as TS or OCD. Appropriate treatment of these dermatological complications includes not only management of the skin condition, but also a referral to a neurologist or a psychiatrist. While self-mutilatory behavior resulting in skin injury may simply be a response in some individuals to stress, frustration, or boredom, it is also a recognized consequence of schizophrenia, depression, personality disorder, Lesch-Nyhan syndrome, Cornelia de Lange syndrome, neuroacanthocytosis, OCD, TS, and other neurobehavioral disorders.4 Patients with these disorders may injure their skin and appendages during repetitive head banging, compulsive pulling of hair, eyebrows, and eyelashes, biting of cheeks, tongue, and lips, picking at skin and scabs, excessive washing of hands, and other repetitive, compulsive activities.
Jankovic J, Sekula S, Milas D. Dermatological Manifestations of Tourette Syndrome and Obsessive-Compulsive Disorder. Arch Dermatol. 1998;134(1):113-114. doi: