Skin picking (SP) with manipulation of the skin using nails or other tools leads to various degrees of skin damage. Clinical signs of SP on the hands include erythema, erosions and bleeding wounds, crusts, hyperkeratosis, and often loss of the cuticles. The manipulation ranges from relatively normal behavior to self-injurious pathological SP related to compulsive-impulsive behavior or other psychiatric comorbidities causing functional interferences or distress
