2025 ICD-10-CM code L98.1
(Active) Effective Date: N/A Revision Date: N/A Diseases of the skin and subcutaneous tissue - Other disorders of the skin and subcutaneous tissue Diseases of the skin and subcutaneous tissue (L00-L99) Feed
Factitial dermatitis, also known as neurotic excoriation, is a self-inflicted skin lesion.
Medical necessity for treatment of factitial dermatitis is established when the condition leads to significant skin damage, recurrent infections, pain, impairment of daily activities, or significant psychological distress. Treatment aims to heal the skin wounds and address the underlying psychological factors contributing to the self-harming behavior.
The clinical responsibility involves a thorough dermatological examination to assess the extent and severity of the skin lesions, differentiating factitial dermatitis from other skin conditions.This might include skin biopsies, cultures, and possibly allergy testing.Additionally, a mental health evaluation is crucial to identify any underlying psychological factors and initiate appropriate interventions, such as counseling or therapy.
- Diseases of the skin and subcutaneous tissue (L00-L99)
- L98 Other disorders of skin and subcutaneous tissue, not elsewhere classified
In simple words: Factitial dermatitis is a skin problem caused by a person repeatedly picking, scratching, or rubbing their skin. This often happens because of stress or another mental health issue. The damage to the skin can lead to sores, infections, or other problems. Treatment involves taking care of the skin injury and addressing the underlying mental health condition.
Factitial dermatitis (L98.1) is a self-induced skin lesion resulting from the patient's deliberate actions, often associated with underlying psychological conditions such as neurotic excoriation.It involves scratching, picking, or rubbing the skin, leading to various degrees of inflammation, damage, and secondary infections. The diagnosis requires careful examination, ruling out other skin conditions with similar presentations.Treatment focuses on addressing both the physical wounds and the underlying mental health issues.
Example 1: A 30-year-old female presents with chronic, recurrent lesions on her arms and legs, characterized by excoriations, crusting, and secondary infection. She admits to picking at her skin, particularly when stressed or anxious.This is a classic presentation of factitial dermatitis, where the physical manifestation reflects an underlying anxiety disorder., A 17-year-old male with a history of obsessive-compulsive disorder exhibits multiple scabs and excoriations on his face, consistent with self-inflicted trauma. He reports an irresistible urge to pick and scratch his skin, despite the resulting inflammation and scarring. This case highlights the comorbidity of factitial dermatitis and obsessive-compulsive disorder., A 55-year-old woman presents with chronic wounds on her thighs, initially misdiagnosed as venous ulcers. However, further investigation, including a mental health assessment, reveals a history of self-mutilation and stress-induced skin picking. The case demonstrates the importance of thorough history-taking and recognizing the psychological components of factitial dermatitis.
Detailed description of the lesions, including location, size, shape, and presence of secondary infection.Documentation of any self-reported behaviors such as scratching, picking, or rubbing.Results of any laboratory tests, such as skin cultures or biopsies.Mental health assessment, including any history of underlying psychological conditions.Photographs of the lesions can be helpful for documentation and tracking treatment progress.
** Factitial dermatitis can be challenging to diagnose and manage, often requiring a multidisciplinary approach involving dermatologists and mental health professionals.The severity of the condition and the response to treatment may vary greatly depending on the underlying psychological factors.
- Payment Status: Active
- Specialties:Dermatology, Psychiatry
- Place of Service:Office, Hospital, Outpatient clinic