The Global Prevalence of Primary Psychodermatologic Disorders: A Systematic Review

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• This systematic literature review included 60 articles that provide insight into the prevalence of psychodermatologic disorders (PPDs), such as delusional parasitosis, skin picking disorder, trichotillomania, tanning dependence, and repetitive nail biting. Skin picking prevailed as the most common PPD, and delusional parasitosis appeared to be the least common; however, there was much heterogeneity between the studies.

• The average prevalence of PPDs was approximately 1% in the general population, with skin picking being the most common.

–  Joshua R. Ortego, MD

Abstract 

The management of primary psychodermatologic disorders (PPDs) (i.e., psychiatric disorders with dermatologic presentation) is challenging. The scarceness of reported prevalence hinders the development of coordinated interventions to improve healthcare delivery. This review aimed to explore the global prevalence of PPDs. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Of the 4632 identified publications, 60 were included. Five PPDs were investigated from the included studies: delusional parasitosis (n=9), skin picking disorder (n=26), trichotillomania (n=22), tanning dependence (n=5), and repetitive nail biting (n=6). Delusional parasitosis was rare in the general population (prevalence ranging from 0.0002% to 0.03%), with higher rates in the psychiatric settings (outpatient=0.5%; inpatient=0.1%). Other pathologic or subclinical forms of PPDs had a minimum prevalence of 0.3% (median=7.0%; mean=17.0%). The distribution of the prevalence rates was highly skewed, with large differences based on the study setting (e.g., dermatologic settings, psychiatric settings, and general population). The most common condition was pathologic skin picking (prevalence, 1.2%-11.2%) in the general population. Its rates were higher in the psychiatric settings (obsessive-compulsive disorder, 38.5%; Tourette syndrome, 13.0%; body dysmorphic disorder, 26.8%-64.7%). The prevalence of trichotillomania in the general population ranged from 0.6% to 2.9%, while that of pathologic tanning and nail biting could not be ascertained as the studies were mainly in students (range; 12.0%-39.3% and 3.0%-10.1%, respectively). In conclusion, PPDs are common, especially in the dermatologic and psychiatric settings. Further population-based studies are needed to determine more accurate prevalence rates.

Journal of the European Academy of Dermatology and Venereology: JEADV

The Global Prevalence of Primary Psychodermatologic Disorders: A Systematic Review

J Eur Acad Dermatol Venereol 2022 Aug 04;[EPub Ahead of Print], T Turk, C Liu, S Straube, M Dytoc, R Hagtvedt, L Dennett, A Abba-Aji, E Fujiwara 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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