Adult women with acne excoriée form a special group who do not recover with dermatological treatment. In many the habit of excoriation persists for years after there has been no evidence of acne and in some it is doubtful whether they had acne vulgaris at the outset, the dividing line between acne excoriée and neurotic excoriations confined to the face being tenuous. We have studied eight women who have suffered from excoriations on the face only, which have persisted for up to 20 years. Psychiatric investigation has shown that in a large proportion the excoriations have been used as a protective device to conceal an emotional failure. Improvement in the dermatosis after treatment with phenothiazines and psychotherapy have revealed in many a phobic state which had previously been hidden even from the patient.
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Sneddon et al. (1983) studied this question.
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