{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T12:55:34Z","timestamp":1774097734617,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,3,29]],"date-time":"2020-03-29T00:00:00Z","timestamp":1585440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Pathological skin picking (PSP) is characterized by repetitive scratching, biting, and picking of the skin. The disorder is subsumed under the section \u201cobsessive\u2010compulsive and related disorders\u201d in the <jats:italic>DSM\u20105<\/jats:italic>. A related body\u2010focused repetitive disorder, which has received less empirical attention so far, is dermatophagia or dermatodaxia (eating or biting\/gnawing of the skin). Habit reversal training (HRT) is regarded as the treatment of choice demonstrating improvement at a medium effect size relative to control conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present case report describes a 50\u2010year\u2010old man with a lifetime history of PSP and dermatodaxia of the fingertips who stopped excessive nail\u2010biting approximately 10\u00a0years ago using a treatment method known as decoupling. Yet, his PSP and dermatodaxia remained treatment\u2010refractory after treatment with both decoupling (conventional protocol) and HRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using a revised protocol of decoupling, the man was able to fully stop PSP and dermatodaxia; only the tendency to fidget nervously with his hands remained. The case report describes the revised protocol. Scores on the Skin Picking Scale Revised (SPS\u2010R) dropped from 15 to 0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The revised decoupling protocol is an easy to use technique that holds promise in this underdiagnosed and undertreated condition. Yet, rigorous randomized controlled studies are needed to ascertain its efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13378","type":"journal-article","created":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T06:38:01Z","timestamp":1585550281000},"page":"3038-3040","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Recovery from pathological skin picking and dermatodaxia using a revised decoupling protocol"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8601-0143","authenticated-orcid":false,"given":"Steffen","family":"Moritz","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4964-4213","authenticated-orcid":false,"given":"Michael","family":"Rufer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital University of Z\u00fcrich Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stella","family":"Schmotz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,29]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2012.12040508"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145445502026003002"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2009.01.008"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2009.04.003"},{"issue":"1","key":"e_1_2_4_6_1","first-page":"19","article-title":"Dermatophagia: \u201cwolf\u2010biter\u201d","volume":"59","author":"Scott MJ","year":"1997","journal-title":"Cutis"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2005.04.021"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(73)90119-8"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.03.013"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocrd.2011.11.001"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2010.07.001"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145445511409395"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjocd.13378","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.13378","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.13378","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.13378","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T07:03:50Z","timestamp":1693724630000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.13378"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,29]]},"references-count":11,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/jocd.13378"],"URL":"https:\/\/doi.org\/10.1111\/jocd.13378","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,29]]},"assertion":[{"value":"2019-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}