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There have been many different theories regarding the causes of excoriation disorder, including biological and environmental factors. [10]A common hypothesis is that excoriation disorder is often a coping mechanism to deal with elevated levels of turmoil, boredom, anxiety, or stress within the individual, and that the individual has an impaired stress response.
Diagramatic representation of mucosal erosion (left), excoriation (center), and ulceration (right) Simplistic representation of the life cycle of mouth ulcers. An ulcer (/ ˈ ʌ l s ər /; from Latin ulcus, "ulcer, sore") [2] is a break in the skin or mucous membrane with loss of surface tissue and the disintegration and necrosis of epithelial tissue. [3]
Unhealed, excoriated lesions are often scaly, crusted or scabbed. Many patients report a lack of wound healing even when medications relieve the itching and consequent scratching. [citation needed] Patients often: [citation needed] seek treatment during middle-age, although PN can occur at any age. have a history of chronic severe pruritus.
Excoriation: A punctate or linear abrasion produced by mechanical means (often scratching), usually involving only the epidermis, but commonly reaching the papillary dermis. [ 30 ] [ 33 ] Ulcer : An ulcer is a discontinuity of the skin exhibiting complete loss of the epidermis and often portions of the dermis.
Pressure ulcers can trigger other ailments, cause considerable suffering, and can be expensive to treat. Some complications include autonomic dysreflexia, bladder distension, bone infection, pyarthrosis, sepsis, amyloidosis, anemia, urethral fistula, gangrene and very rarely malignant transformation (Marjolin's ulcer – secondary carcinomas in chronic wounds).
Chronic ulcer symptoms usually include increasing pain, friable granulation tissue, foul odour, and wound breakdown instead of healing. [3] Symptoms tend to worsen once the wound has become infected. Venous skin ulcers that may appear on the lower leg, above the calf or on the lower ankle usually cause achy and swollen legs.
Lichen simplex chronicus (LSC) is thick leathery skin with exaggerated skin markings caused by sudden itching and excessive rubbing and scratching. [1] It generally results in small bumps, patches, scratch marks and scale. [1]
Dermatitis artefacta, also known as Factitious dermatitis, is a form of factitious disorder in which patients will intentionally feign symptoms and produce signs of disease in an attempt to assume the patient role.