Differential Diagnosis
- Single most likely diagnosis
- Skin picking disorder (also known as dermatillomania or psychogenic excoriation): This condition is characterized by repetitive and compulsive picking at one's own skin, leading to skin lesions, bleeding, and scabbing. The behavior can be a coping mechanism for stress, anxiety, or other emotional distress.
- Other Likely diagnoses
- Eczema (atopic dermatitis): A chronic skin condition that can cause dry, itchy, and inflamed skin, leading to scratching and picking, which can result in bleeding and scabbing.
- Psoriasis: An autoimmune skin condition that can cause red, scaly, and itchy patches, which can lead to picking and bleeding.
- Insect bites or infestations (e.g., scabies, bed bugs): Repeated scratching and picking at insect bites can cause bleeding, scabbing, and persistent lesions.
- Folliculitis: An inflammation of the hair follicles, often caused by bacterial or fungal infections, which can lead to picking, bleeding, and scabbing.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Skin cancer (e.g., basal cell carcinoma, squamous cell carcinoma): Although less likely, it is essential to consider skin cancer in the differential diagnosis, as some types can present with bleeding, scabbing, and persistent lesions.
- Vasculitis: A group of disorders that cause inflammation of blood vessels, which can lead to skin lesions, bleeding, and scabbing.
- Infectious diseases (e.g., MRSA, cellulitis): Bacterial or fungal infections can cause skin lesions, bleeding, and scabbing, and can be life-threatening if left untreated.
- Rare diagnoses
- Neurotic excoriations: A rare condition characterized by repetitive and compulsive picking at one's own skin, often associated with underlying psychiatric conditions.
- Factitious disorder: A condition in which a person intentionally creates or fakes symptoms, including skin lesions, to gain attention or sympathy.
- Delusional parasitosis: A rare psychiatric condition in which a person believes they are infested with parasites, leading to repetitive picking and scratching at the skin.