摳皮症之探究

Excoriation (Skin-Picking) Disorder

摳皮症主要表現是無法克制的反覆地挖、擠、抓、刺、採和咬皮膚所造成的困擾，2013年Diagnostic and Statistical Manual of Mental Disorders 5th edition （DSM-5）才將其放在強迫症及相關障礙症中。目前對於 摳皮症的生理、病理機轉及治療方式所知有限，最常用的藥物為selective serotonin reuptake inhibitors（SSRIs），國外研究顯示fluoxetine、citalopram、fluvoxamine、escitalopram、Sertraline被使用，而lamotrigine亦被用於降低摳皮症的嚴重程度。研究顯示認知行為療法有助於治療摳皮症，例如習慣逆轉訓練、接受和承諾療法都有不錯的效果。鑑於國內對於摳皮症相關研究付之闕如，藉由探討相關文獻，以期對摳皮症之流行病學、診斷、病因、共病現象、治療方法等有更全面性的認識與瞭解。 The main manifestation of excoriation (skin-picking) disorder (ExD) is the inability to restrain and repeatedly digging, squeezing, scratching, stabbing, rubbing, and biting the skin, which leads to trouble. The 2013 DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th edition) places ExD in obsessive compulsive disorder and related disorders. At present, there are limited knowledge about the physiology, pathogenesis and treatment of it. The most commonly used drugs are selective serotonin reuptake inhibitors (SSRIs). Fluoxetine, citalopram, fluvoxamine, escitalopram and sertraline have been used in foreign studies. Lamotrigine is also used to reduce the severity of excoriation. Research has also shown that cognitive-behavioral therapy helps to treat ExD, such as habit-reversal training, acceptance and commitment therapy both have good effects. Since there are just too few researches of ExD in our country, we should study relevant literature across the world first. The literature study and discussion might help us better understand about the epidemiology, diagnosis, etiology, comorbidity and treatment of ExD.