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  • Emotional regulation, dissociation, and the self-induced dermatoses: clinical features and implications for treatment with mood stabilizers.

Emotional regulation, dissociation, and the self-induced dermatoses: clinical features and implications for treatment with mood stabilizers.

Clinics in dermatology (2012-12-19)
Madhulika A Gupta
ABSTRACT

The self-induced dermatoses (such as trichotillomania, pathologic skin picking or neurotic excoriations, dermatitis artefacta, onychophagia and onychotillomania), which are caused as a result of excessive manipulation of the skin, hair, and nails by the patient, can contribute to significant morbidity and can even complicate the course of a primary dermatologic condition such as acne (eg, in acne excoriée) and some pruritic dermatoses. Reports on the self-induced dermatoses in the past decade have tended to focus upon the specific motor behaviors involved in self-inducing the lesions (ie, skin picking or hair pulling) rather than address the common psychopathologic factors underlying the self-injurious behaviors. In the current psychiatric nosology (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) the self-induced dermatoses are classified as Impulse Control Disorders and Stereotypic Movement Disorders, and this classification does not adequately consider the fact that in most patients with self-induced dermatoses, the frequency and severity of the self-injurious behaviors are directly related to acute or chronic problems with emotional regulation and dissociation. This may be part of the reason that there is a relative paucity of effective treatments for these disorders. The skin and its appendages are well innervated with a dense network of afferent sensory nerves and efferent autonomic nerves, and the integumentary system is frequently the focus of tension-reducing and emotion-regulating behaviors, especially during states of autonomic nervous system hyperarousal. This factor is important in the pathogenesis of the self-induced dermatoses. Mood-stabilizing agents, such as lithium carbonate, that are used to treat disorders of emotional regulation have not been adequately studied in the management of the self-induced dermatoses and may prove to be very helpful in the management of these disorders.

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Sigma-Aldrich
Lithium carbonate, 99.997% trace metals basis
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Sigma-Aldrich
Lithium carbonate, puriss. p.a., ACS reagent, reagent (for microscopy), ≥99.0% (T)
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SKUPack SizeAvailabilityPriceQuantity
100 mL
In Stock
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$213.00
1 L
Estimated to ship on March 24, 2025
$274.00
2 L
Estimated to ship on March 24, 2025
$343.00
Sigma-Aldrich
Lithium carbonate, ACS reagent, ≥99.0%
Sign Into View Organizational & Contract Pricing
SKUPack SizeAvailabilityPriceQuantity
100 mL
In Stock
Details...
$213.00
1 L
Estimated to ship on March 24, 2025
$274.00
2 L
Estimated to ship on March 24, 2025
$343.00
Sigma-Aldrich
Lithium carbonate, 99.999% trace metals basis
Sign Into View Organizational & Contract Pricing
SKUPack SizeAvailabilityPriceQuantity
100 mL
In Stock
Details...
$213.00
1 L
Estimated to ship on March 24, 2025
$274.00
2 L
Estimated to ship on March 24, 2025
$343.00