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Two Case Reports

Julia K. Warnock, MD, PhD; Thelda Kestenbaum, MD

Arch Dermatol. 1992;128(12):1623-1625.

Abstract
• Background.
—Prader-Willi syndrome (PWS) is characterized by hypotonia at birth, hypogonadism, early childhood obesity, and mental deficiency. Other behavioral symptoms that become prominent during adolescence and adulthood include temper outbursts, stealing and hoarding food, and skin picking. The self-excoriating skin picking behavior observed in individuals with PWS is quite common and can lead to persistent sores and infections, even requiring hospitalization.

Observation.
—Two patients with PWS who displayed repetitive, self-mutilatory behavior of skin picking are described. They were both treated successfully with different doses of fluoxetine, a selective serotonin reuptake inhibitor.

Conclusions.
—The skin-picking behavior in patients with PWS may be a variant of the spectrum of obsessive-compulsive disorders. Obsessive-compulsive disorders have been successfully treated with serotonin reuptake inhibitors such as fluoxetine. Thus, fluoxetine may be considered an opon in the management of skin-picking behavior in patients with PWS.

Author Affiliations
From the Departments of Psychiatry (Dr Warnock) and Dermatology (Dr Kestenbaum), University of Kansas Medical Center, Kansas City.

Footnotes
Accepted for publication July 28, 1992.

Read before the Fourth International Congress on Dermatology and Psychiatry, Philadelphia, Pa, June 20, 1992.

Reprint requests to Department of Psychiatry, 3901 Rainbow Blvd, Kansas City, KS 66106 (Dr Warnock).

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