Dermatillomania

Jeremiah is a 75-year-old widowed male residing in a senior housing complex with in-home aide support. Skin-picking behavior began in his late 60s with minor blemishes on his forearms and intensified following his wife's death five years ago, expanding to his face, neck, and scalp. He currently presents with visible irritation, redness, and bleeding at picking sites, reporting brief relief or satisfaction followed by guilt and shame. The behavior has been observed by family and friends during casual activities. Prior interventions — including self-directed strategies (sleeves, bandaging) and dermatological advice (moisturizer, skin coverage) — have provided no sustained improvement. He avoids social events and experiences notable discomfort at medical appointments.