Trichotillomania in Attention-Deficit/Hyperactivity Disorder Under Methylphenidate Treatment

Adverse psychocutaneous effects of prescription stimulant use and abuse: A systematic review

Although rare, psychocutaneous disorders induced by prescription stimulants have been reported throughout the literature. A systematic review was conducted to identify all case reports and case series of prescription stimulant-induced trichotillomania, tactile hallucinations, and delusional infestation. A total of 22 case reports were identified and relevant information was analyzed. Patients presenting with trichotillomania and tactile hallucinations induced by prescription stimulants were typically pediatric male patients being treated for attention deficit hypersensitivity disorder. Symptoms resolved after discontinuation of the offending medication. Patients presenting with delusional infestation secondary to stimulant use or abuse were typically adults who were misusing or abusing stimulant medication. Although symptoms typically improved or resolved after decreasing or discontinuing medication, several patients required the use of antipsychotic medication. While the observational nature of case reports and small number of patients limits meaningful analysis of trends and comparison, this study demonstrates that physicians, especially dermatologists and psychiatrists, should be aware of the potential for prescription stimulants to precipitate adverse psychocutaneous disorders in a minority of individuals.

Cessation of Skin Picking Symptoms With Methylphenidate Treatment in a Child With Comorbid Skin Picking and Attention-Deficit/Hyperactivity Disorder

Skin picking disorder includes behaviors such as picking, scratching, and squeezing of the normal skin in an impulsive, repetitive manner despite the fact that no dermatological condition is detected. Skin picking disorder may also be comorbid in children with attention-deficit/hyperactivity disorder (ADHD) and vice versa. There is a great deal of data regarding the efficacy and safety of methylphenidate (MPH) treatment of ADHD. In this article, we report the cessation of skin picking behaviors in a 10-year-old girl diagnosed as having skin picking disorder and ADHD after modified-release MPH treatment. To our knowledge, this is the first case report that shows the cessation of skin picking behavior after MPH treatment in a child with ADHD.

Newly Developed Skin Picking After Methylphenidate Treatment in Attention Deficit Hyperactivity Disorder: Possible Mechanisms

Dermatillomania is characterized by excessive and repeated skin picking sufficient to damage cutaneous tissue, but with no underlying dermatological disease. The condition appears as an independent diagnosis in the Obsessive-Compulsive and Related Disorders category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A psychiatric pathology is generally reported to accompany this symptom. Attention deficit hyperactivity disorder (ADHD) is a potentially lifelong condition involving inattentiveness, hyperactivity, and impulsiveness. Attention deficit hyperactivity disorder is one of the most common childhood psychiatric disorders. Treatment includes medication, psychotherapy, and psychosocial therapies. Psychostimulants constitute the basis of treatment of children with ADHD worldwide. We describe a case of skin picking developing after methylphenidate therapy for ADHD. Possible explanations of methylphenidate and skin picking are reviewed in the light of the current literature.