{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:03:00Z","timestamp":1781877780032,"version":"3.54.5"},"reference-count":85,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Chronic pruritus (CP), attention-deficit\/hyperactivity disorder (ADHD), and skin picking disorder (SPD) are medical conditions that involve both somatic and psychosocial dimensions, posing unique challenges in clinical management. While CP and SPD are often observed together, the link between ADHD and these conditions is less recognized. This conceptual work describes three women who suffered from a complex interplay of CP, ADHD, and SPD treated at our specialized bi-disciplinary psychodermatological pruritus clinic. Based on our clinical observation and a narrative review of the literature, we assume a bidirectional, triangular relationship between CP, ADHD, and SPD. To support this assumption, we propose two hypotheses: (1) a neurodevelopmental hypothesis, emphasizing that an underlying neurodevelopmental disorder, in this case, ADHD, might present with symptoms like dysfunction of sensory processing, impulsivity, and attention deficits as shared features that reinforce CP and SPD, and (2) a neuroinflammatory hypothesis, suggesting that similar neuroinflammatory signatures promote the co-occurrence of CP, ADHD, and SPD. In addition, we provide specific suggestions derived from our clinical experience on how to manage patients with this complex combination of conditions. Elucidating the interplay between CP, ADHD, and SPD might help develop personalized treatment strategies and improve outcomes.<\/jats:p>","DOI":"10.3390\/jcm14051774","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T06:02:13Z","timestamp":1741240933000},"page":"1774","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Relationship Between Chronic Pruritus, Attention-Deficit\/Hyperactivity Disorder, and Skin Picking\u2014A Case Series and Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Eva","family":"Loos","sequence":"first","affiliation":[{"name":"Department of Dermatology, University Hospital and University of Basel, CH-4031 Basel, Switzerland"},{"name":"Department of Psychosomatic Medicine, University Hospital and University of Basel, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzan","family":"Sekar","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital and University of Basel, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Rosin","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, University Hospital and University of Basel, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander A.","family":"Navarini","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital and University of Basel, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrysovalandis","family":"Schwale","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, University Hospital and University of Basel, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3077-7289","authenticated-orcid":false,"given":"Rainer","family":"Schaefert","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, University Hospital and University of Basel, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0200-4254","authenticated-orcid":false,"given":"Simon","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital and University of Basel, CH-4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s11882-015-0532-2","article-title":"The Other Itch That Rashes: A Clinical and Therapeutic Approach to Pruritus and Skin Picking Disorders","volume":"15","author":"Reichenberg","year":"2015","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"908","DOI":"10.2340\/actadv.v101.908","article-title":"Skin Picking in Atopic Dermatitis and Psoriasis Patients: A Single-centre Cross-sectional Study in China","volume":"102","author":"Ju","year":"2022","journal-title":"Acta Derm. Venereol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/S0190-9622(98)70087-8","article-title":"How should we define itching?","volume":"39","author":"Savin","year":"1998","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2340\/00015555-0305","article-title":"Clinical Classification of Itch: A Position Paper of the International Forum for the Study of Itch","volume":"87","author":"Weisshaar","year":"2007","journal-title":"Acta Derm. Venereol."},{"key":"ref_5","unstructured":"World Health Organization (2022). International Classification of Diseases Eleventh Revision (ICD-11), World Health Organization."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1001\/jama.2024.4899","article-title":"Chronic Pruritus: A Review","volume":"331","author":"Butler","year":"2024","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1159\/000319862","article-title":"Prevalence of Chronic Pruritus in Germany: Results of a Cross-Sectional Study in a Sample Working Population of 11,730","volume":"221","author":"Phan","year":"2010","journal-title":"Dermatology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1192\/bjp.bp.107.048827","article-title":"Prevalence and correlates of adult attention-deficit hyperactivity disorder: Meta-analysis","volume":"194","author":"Simon","year":"2009","journal-title":"Br. J. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jpsychires.2023.03.034","article-title":"Prevalence and gender distribution of excoriation (skin-picking) disorder: A systematic review and meta-analysis","volume":"161","author":"Farhat","year":"2023","journal-title":"J. Psychiatr. Res."},{"key":"ref_10","unstructured":"Weisshaar, E., Szepietowski, J.C., Dalgard, F.J., Garcovich, S., Gieler, U., Gimenez-Arnau, A.M., Lambert, J., Leslie, T., Mettang, T., and Misery, L. (2024, July 19). European S2k Guideline on Chronic Pruritus. Available online: https:\/\/publicatt.unicatt.it\/handle\/10807\/168850."},{"key":"ref_11","unstructured":"AWMF (2024, November 24). Long Version of the Interdisciplinary, Evidence-and Consensus-Based (S3) Guidelines \u2018Attention Deficit Hyperactivity Disorder (ADHD) in Children, Adolescents and Adults\u2019. AWMF-Registernummer 028-045. Available online: https:\/\/register.awmf.org\/assets\/guidelines\/028_D_G_f_Kinder-_und_Jugendpsychiatrie_und_-psychotherapie\/028-045eng_S3_ADHS_2020-12-abgelaufen.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/papt.12427","article-title":"The problem with picking: Permittance, escape and shame in problematic skin picking","volume":"96","author":"Anderson","year":"2023","journal-title":"Psychol. Psychother. Theory Res. Pract."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e13661","DOI":"10.1111\/dth.13661","article-title":"Psychodermatology of skin picking (excoriation disorder): A comprehensive review","volume":"33","author":"Torales","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.jbtep.2010.01.009","article-title":"Emotion regulation in pathological skin picking: Findings from a non-treatment seeking sample","volume":"41","author":"Snorrason","year":"2010","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"5854","DOI":"10.2340\/00015555-3605","article-title":"The Pleasurability of Scratching an Itch Amongst Different Pruritic Conditions","volume":"100","author":"Golpanian","year":"2020","journal-title":"Acta Derm. Venereol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Papoiu, A.D.P., Nattkemper, L.A., Sanders, K.M., Kraft, R.A., Chan, Y.-H., Coghill, R.C., and Yosipovitch, G. (2013). Brain\u2019s Reward Circuits Mediate Itch Relief. A Functional MRI Study of Active Scratching. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0082389"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/j.jaad.2019.06.031","article-title":"Symptoms of depression and anxiety are associated with poorer functional outcomes in chronic pruritus","volume":"85","author":"Cole","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.jdin.2021.02.004","article-title":"Association between chronic pruritus, depression, and insomnia: A cross-sectional study","volume":"3","author":"Lee","year":"2021","journal-title":"JAAD Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e288","DOI":"10.1111\/jdv.15559","article-title":"Chronic pruritus patients with psychiatric and psychosomatic comorbidity are highly burdened: A longitudinal study","volume":"33","author":"Schneider","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1111\/jdv.19913","article-title":"Dermatological patients with itch report more stress, stigmatization experience, anxiety and depression compared to patients without itch: Results from a European multi-centre study","volume":"38","author":"Zeidler","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"152338","DOI":"10.1016\/j.comppsych.2022.152338","article-title":"Characteristics of 262 adults with skin picking disorder","volume":"117","author":"Grant","year":"2022","journal-title":"Compr. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1111\/ddg.14830","article-title":"S2k guideline: Diagnosis and treatment of chronic pruritus","volume":"20","author":"Zeidler","year":"2022","journal-title":"JDDG J. Dtsch. Dermatol. Ges."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.jaad.2024.06.045","article-title":"Device-based physical therapies in chronic pruritus: A narrative review","volume":"91","author":"Zhu","year":"2024","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.2147\/NDT.S121138","article-title":"Excoriation (skin-picking) disorder: A systematic review of treatment options","volume":"13","author":"Lochner","year":"2017","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1097\/JCP.0000000000000462","article-title":"Systematic Review of Pharmacological and Behavioral Treatments for Skin Picking Disorder","volume":"36","author":"Schumer","year":"2016","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"adv00401","DOI":"10.2340\/00015555-3701","article-title":"Investigator\u2019s Global Assessment of Chronic Prurigo: A New Instrument for Use in Clinical Trials","volume":"101","author":"Zeidler","year":"2021","journal-title":"Acta Derm. Venereol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/0895-4356(96)00119-9","article-title":"Development and validation of diagnostic scores for atopic dermatitis incorporating criteria of data quality and practical usefulness","volume":"49","author":"Diepgen","year":"1996","journal-title":"J. Clin. Epidemiol."},{"key":"ref_28","first-page":"155","article-title":"Testbesprechung: Homburger ADHS-Skalen f\u00fcr Erwachsene (HASE)","volume":"56","author":"Schmidt","year":"2008","journal-title":"Z. F\u00fcr Psychiatr. Psychol. Und Psychother."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"562","DOI":"10.2340\/00015555-1544","article-title":"German version of ItchyQoL: Validation and initial clinical findings","volume":"93","author":"Krause","year":"2013","journal-title":"Acta Derm. Venereol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1026\/1616-3443\/a000386","article-title":"Pathologisches Hautzupfen\/-quetschen (Skin Picking)","volume":"46","author":"Mehrmann","year":"2017","journal-title":"Z. Klin. Psychol. Psychother."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jad.2008.06.026","article-title":"The PHQ-8 as a measure of current depression in the general population","volume":"114","author":"Kroenke","year":"2009","journal-title":"J. Affect. Disord."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1001\/jamainternmed.2013.12179","article-title":"The Somatic Symptom Scale\u20138 (SSS-8): A Brief Measure of Somatic Symptom Burden","volume":"174","author":"Gierk","year":"2014","journal-title":"JAMA Intern. Med."},{"key":"ref_34","unstructured":"Linde, K., Riedl, B., Kehrer, S., Schneider, A., L\u00f6we, B., and Toussaint, A. (2024, July 26). Der Fragebogen SSD-12 zur Erfassung der Psychischen Belastung bei Somatischer Belastungsst\u00f6rung\u2014Erste Erfahrungen und Validierung bei Hausarztpatienten. 51 Kongress f\u00fcr Allgemeinmedizin und Familienmedizin. Available online: http:\/\/www.egms.de\/en\/meetings\/degam2017\/17degam143.shtml."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1001\/jamapsychiatry.2016.0060","article-title":"N-Acetylcysteine in the Treatment of Excoriation Disorder: A Randomized Clinical Trial","volume":"73","author":"Grant","year":"2016","journal-title":"JAMA Psychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1159\/000533366","article-title":"Associations of Atopic Dermatitis with Attention Deficit\/Hyperactivity Disorder and Autism Spectrum Disorder: A Systematic Review and Meta-Analysis","volume":"240","author":"Cheng","year":"2023","journal-title":"Dermatology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1089\/ped.2016.0705","article-title":"Attention-Deficit\/Hyperactivity Disorder in Atopic Dermatitis: An Appraisal of the Current Literature","volume":"29","author":"Nygaard","year":"2016","journal-title":"Pediatr. Allergy Immunol. Pulmonol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1111\/bjd.14697","article-title":"Association between atopic dermatitis and attention deficit hyperactivity disorder in U.S. children and adults","volume":"175","author":"Strom","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.psyneuen.2012.09.017","article-title":"Psychoendocrine and psychoneuroimmunological mechanisms in the comorbidity of atopic eczema and attention deficit\/hyperactivity disorder","volume":"38","author":"Schmitt","year":"2013","journal-title":"Psychoneuroendocrinology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.neubiorev.2017.01.011","article-title":"Association of atopic diseases and attention-deficit\/hyperactivity disorder: A systematic review and meta-analyses","volume":"74","author":"Hak","year":"2017","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1038\/s41380-022-01829-8","article-title":"Ectodermal origins of the skin-brain axis: A novel model for the developing brain, inflammation, and neurodevelopmental conditions","volume":"28","author":"Jameson","year":"2023","journal-title":"Mol. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/all.15818","article-title":"Mind and skin: Exploring the links between inflammation, sleep disturbance and neurocognitive function in patients with atopic dermatitis","volume":"79","author":"Cameron","year":"2024","journal-title":"Allergy"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Chang, S.-J., Kuo, H.-C., Chou, W.-J., Tsai, C.-S., Lee, S.-Y., and Wang, L.-J. (2022). Cytokine Levels and Neuropsychological Function among Patients with Attention-Deficit\/Hyperactivity Disorder and Atopic Diseases. J. Pers. Med., 12.","DOI":"10.3390\/jpm12071155"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.comppsych.2016.02.003","article-title":"Body focused repetitive behavior disorders: Significance of family history","volume":"66","author":"Redden","year":"2016","journal-title":"Compr. Psychiatry"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"115120","DOI":"10.1016\/j.psychres.2023.115120","article-title":"Characteristics of trichotillomania and excoriation disorder across the lifespan","volume":"322","author":"Lin","year":"2023","journal-title":"Psychiatry Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2332\/allergolint.13-RAI-0564","article-title":"New Insights into Atopic Dermatitis: Role of Skin Barrier and Immune Dysregulation","volume":"62","author":"Leung","year":"2013","journal-title":"Allergol. Int."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1016\/j.it.2018.10.001","article-title":"The Itch\u2013Scratch Cycle: A Neuroimmune Perspective","volume":"39","author":"Mack","year":"2018","journal-title":"Trends Immunol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1111\/j.1460-9568.2009.06669.x","article-title":"Changes in alternative brain-derived neurotrophic factor transcript expression in the developing human prefrontal cortex","volume":"29","author":"Wong","year":"2009","journal-title":"Eur. J. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1038\/s41380-024-02413-y","article-title":"Brain-derived neurotrophic factor from microglia regulates neuronal development in the medial prefrontal cortex and its associated social behavior","volume":"29","author":"Komori","year":"2024","journal-title":"Mol. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/j.jaci.2005.02.007","article-title":"Brain-derived neurotrophic factor is increased in atopic dermatitis and modulates eosinophil functions compared with that seen in nonatopic subjects","volume":"115","author":"Raap","year":"2005","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_51","first-page":"100870","article-title":"Sensory processing in skin picking disorder","volume":"41","author":"Collins","year":"2024","journal-title":"J. Obs. Compuls. Relat. Disord."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Grossman, A., and Avital, A. (2023). Emotional and sensory dysregulation as a possible missing link in attention deficit hyperactivity disorder: A review. Front. Behav. Neurosci., 17.","DOI":"10.3389\/fnbeh.2023.1118937"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.jad.2017.11.035","article-title":"Emotion regulation deficits in persons with body-focused repetitive behavior disorders","volume":"227","author":"Alexander","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/s11920-019-1122-0","article-title":"Mechanisms of Tactile Sensory Phenotypes in Autism: Current Understanding and Future Directions for Research","volume":"21","author":"Schaffler","year":"2019","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s40263-019-00621-7","article-title":"Skin-Picking Disorder: A Guide to Diagnosis and Management","volume":"33","author":"Jafferany","year":"2019","journal-title":"CNS Drugs"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.clindermatol.2023.03.003","article-title":"\u201cPick\u201d wisely: An approach to diagnosis and management of pathologic skin picking","volume":"41","author":"Parsa","year":"2023","journal-title":"Clin. Dermatol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1111\/pde.13710","article-title":"Neurocognitive function in moderate\u2013severe pediatric atopic dermatitis: A case\u2013control study","volume":"36","author":"Kruse","year":"2019","journal-title":"Pediatr. Dermatol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.pbb.2019.05.005","article-title":"Neuroinflammation as a risk factor for attention deficit hyperactivity disorder","volume":"182","author":"Dunn","year":"2019","journal-title":"Pharmacol. Biochem. Behav."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.psyneuen.2018.12.005","article-title":"Altered hypothalamus-pituitary-adrenal axis function: A relevant factor in the comorbidity of atopic eczema and attention deficit\/hyperactivity disorder?","volume":"105","author":"Trikojat","year":"2019","journal-title":"Psychoneuroendocrinology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1111\/exd.14851","article-title":"Investigating causal relationships between genetically determined increased risk of attention-deficit\/hyperactivity disorder (ADHD) and atopic dermatitis (AD): A Mendelian randomization analysis","volume":"32","author":"Ng","year":"2023","journal-title":"Exp. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Acevedo, N., Benfeitas, R., Katayama, S., Bruhn, S., Andersson, A., Wikberg, G., Lundeberg, L., Lindvall, J.M., Greco, D., and Kere, J. (2020). Epigenetic alterations in skin homing CD4+CLA+ T cells of atopic dermatitis patients. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-74798-z"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Chua, R.X.Y., Tay, M.J.Y., Ooi, D.S.Q., Siah, K.T.H., Tham, E.H., Shek, L.P.-C., Meaney, M.J., Broekman, B.F.P., and Loo, E.X.L. (2020). Understanding the Link Between Allergy and Neurodevelopmental Disorders: A Current Review of Factors and Mechanisms. Front. Neurol., 11.","DOI":"10.3389\/fneur.2020.603571"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/978-981-19-7376-5_15","article-title":"A Potential Role for Neuroinflammation in ADHD","volume":"1411","author":"Corona","year":"2023","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"122713","DOI":"10.1016\/j.lfs.2024.122713","article-title":"Deciphering epigenetic regulations in the inflammatory pathways of atopic dermatitis","volume":"348","author":"Sanabani","year":"2024","journal-title":"Life Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.semcdb.2023.04.005","article-title":"Epigenetic control of inflammation in Atopic Dermatitis","volume":"154","author":"Akhtar","year":"2024","journal-title":"Semin. Cell Dev. Biol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Eapen, A.A., Parameswaran, S., Forney, C., Edsall, L.E., Miller, D., Donmez, O., Dunn, K., Lu, X., Granitto, M., and Rowden, H. (2022). Epigenetic and transcriptional dysregulation in CD4+ T cells in patients with atopic dermatitis. PLoS Genet., 18.","DOI":"10.1371\/journal.pgen.1009973"},{"key":"ref_67","first-page":"27250","article-title":"A Review of Attention-Deficit\/Hyperactivity Disorder in Women and Girls: Uncovering This Hidden Diagnosis","volume":"16","author":"Quinn","year":"2014","journal-title":"Prim. Care Companion CNS Disord."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Young, S., Adamo, N., \u00c1sgeirsd\u00f3ttir, B.B., Branney, P., Beckett, M., Colley, W., Cubbin, S., Deeley, Q., Farrag, E., and Gudjonsson, G. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit\/hyperactivity disorder in girls and women. BMC Psychiatry, 20.","DOI":"10.1186\/s12888-020-02707-9"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1177\/10870547231161533","article-title":"Miss. Diagnosis: A Systematic Review of ADHD in Adult Women","volume":"27","author":"Attoe","year":"2023","journal-title":"J. Atten. Disord."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The Hospital Anxiety and Depression Scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e42","DOI":"10.1097\/itx.0000000000000042","article-title":"IFSI-guideline on chronic prurigo including prurigo nodularis","volume":"5","author":"Pereira","year":"2020","journal-title":"Itch"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1590\/1516-4446-2013-1154","article-title":"N-acetylcysteine in the treatment of skin-picking disorder","volume":"36","author":"Jesus","year":"2014","journal-title":"Braz. J. Psychiatry"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"652","DOI":"10.4103\/ijdvl.IJDVL_33_18","article-title":"N-acetylcysteine in dermatology","volume":"84","author":"Adil","year":"2018","journal-title":"Indian. J. Dermatol. Venereol. Leprol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1590\/1516-4446-2017-2395","article-title":"Skin picking disorder comorbid with ADHD successfully treated with methylphenidate","volume":"40","author":"Bernardes","year":"2018","journal-title":"Braz. J. Psychiatry"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/WNF.0000000000000338","article-title":"Cessation of Skin Picking Symptoms With Methylphenidate Treatment in a Child With Comorbid Skin Picking and Attention-Deficit\/Hyperactivity Disorder","volume":"42","year":"2019","journal-title":"Clin. Neuropharmacol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2340\/00015555-2177","article-title":"Psychological Interventions in the Treatment of Chronic Itch","volume":"96","author":"Schut","year":"2015","journal-title":"Acta Derm. Venereol."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Knight, A.R., Kim, S., Currao, A., Lebas, A., Nowak, M.K., Milberg, W.P., and Fortier, C.B. (2024). Assessing Attention-Deficit\/Hyperactivity Disorder in Post-9\/11 Veterans: Prevalence, Measurement Correspondence, and Comorbidity With Posttraumatic Stress Disorder. Mil. Med., usae539.","DOI":"10.1093\/milmed\/usae539"},{"key":"ref_78","first-page":"1230","article-title":"Executive Dysfunctions: The Role in Attention Deficit Hyperactivity and Post-traumatic Stress Neuropsychiatric Disorders","volume":"7","author":"Prada","year":"2016","journal-title":"Front. Psychol."},{"key":"ref_79","first-page":"30","article-title":"Psychodermatology in Clinical Practice: Main Principles","volume":"96","author":"Marshall","year":"2016","journal-title":"Acta Derm. Venereol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1159\/000073994","article-title":"Joint Consultation by a Psychiatrist and a Dermatologist","volume":"4","author":"Misery","year":"2003","journal-title":"Dermatol. Psychosom. Dermatol. Psychosom."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1001\/jamapsychiatry.2017.0298","article-title":"The World Health Organization Adult Attention-Deficit\/Hyperactivity Disorder Self-Report Screening Scale for DSM-5","volume":"74","author":"Ustun","year":"2017","journal-title":"JAMA Psychiatry"},{"key":"ref_82","first-page":"133","article-title":"The Skin Picking Scale-Revised: Factor structure and psychometric properties","volume":"1","author":"Snorrason","year":"2012","journal-title":"J. Obs. Compuls. Relat. Disord."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1176\/appi.psy.42.5.397","article-title":"The Skin Picking Impact Scale (SPIS): Scale Development and Psychometric Analyses","volume":"42","author":"Keuthen","year":"2001","journal-title":"Psychosomatics"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Ballmann, C., K\u00f6lle, M.A., Bekavac-G\u00fcnther, I., Wolf, F., Pargent, F., Barzel, A., Philipsen, A., and Gensichen, J. (2022). Evaluation of the German Version of the Adult Attention-Deficit\/Hyperactivity Disorder Self-Report Screening Scale for DSM-5 as a Screening Tool for Adult Attention-Deficit\/Hyperactivity Disorder in Primary Care. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.858147"},{"key":"ref_85","first-page":"100743","article-title":"Skin Picking Scale-Revised: Diagnostic accuracy and optimal cut-off scores in university and psychiatric settings","volume":"34","author":"Snorrason","year":"2022","journal-title":"J. Obs. Compuls. Relat. Disord."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/5\/1774\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:48:17Z","timestamp":1760028497000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/5\/1774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,6]]},"references-count":85,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["jcm14051774"],"URL":"https:\/\/doi.org\/10.3390\/jcm14051774","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,6]]}}}