“Sometimes just trying something — showing that you care and will follow up — is the first big step in helping these patients.”

— Dr. Hélène Veillette

In this episode of JCMS Author Interviews, host Dr. Kirk Barber welcomes Dr. Hélène Veillette, Division Head of Dermatology at CHU de Québec–Université Laval, to discuss the article she co-authored with Dr. Louis Deschenes. “Skin Picking Disorder: A Canadian Retrospective Study.” It features in the May-June issue of the JCMS.

Dr. Veillette shares findings from a retrospective review of 82 hospitalized patients diagnosed with skin picking disorder, highlighting the high rate of psychiatric comorbidities, challenges in classification, and the gaps in current dermatologic management. Together, she and Dr. Barber explores how dermatologists can better identify, understand, and manage this complex psychocutaneous condition.

• Why study skin picking disorder?
• How a resident-led idea grew into an important exploration of a frequently overlooked condition.
• Comorbidities and causes:
• 61% of patients had psychiatric comorbidities — most commonly depression, anxiety, personality disorders, and substance-related disorders.
• The team also noted neurocognitive disorders such as dementia, raising questions about causation vs. correlation.
• Clinical presentation:
• Predominantly older women with lesions on accessible areas such as the upper limbs and trunk. Morphologies included excoriations, crusts, plaques, and nodules.
• Diagnostic challenges:
• Review of DSM-5 criteria for skin picking disorder and the ongoing debate about its classification under obsessive-compulsive–related disorders.
• Treatment and management:
• Discussion of first-line therapies like SSRIs and the over-the-counter option N-acetylcysteine (NAC); the importance of multidisciplinary collaboration; and why empathy and follow-up are as critical as prescriptions.
• The role of dermatologists in psychodermatology:
• Dr. Veillette and Dr. Barber emphasize that dermatologists must engage with psychocutaneous conditions rather than refer them away — combining clinical skill with compassion to support these often-suffering patients.

For more on psycho-dermatology, check out episode 86 of JCMS Author Interviews, with Dr. Marlene Dytoc.

Dr Barber and his guests do not receive any financial reimbursement for the production of this podcast.

For more great CDA podcasts check out Dermalogues, our Residents podcast hosted by Dr Kerri Purdy.

To learn more about the work of the Canadian Dermatology Association, please visit our website at dermatology.ca

This podcast is produced by David McGuffin and Graham McGuffin of ExploreProductions.ca