Excoriation Disorder Is Characterized by Systemic Glutamatergic Dysfunction

Excoriation disorder (ED), also known as neurotic excoriations, is a psychocutaneous disorder characterized by repetitive, compulsive picking of the skin leading to secondary tissue damage. ED carries an estimated prevalence of 1.4%, and is associated with significant social dysfunction, as patients often spend several hours each day performing compulsive behaviors leading to absence from work, school or other social events. Despite the significant impact on quality of life, there is still a lack of understanding of the factors involved in disease precipitation or progression, highlighting a need for identification of novel biomarkers of disease. The study of metabolic alterations, through plasma metabolomics, may lead to a greater understanding of disease pathogenesis, as metabolic alterations have been identified in related conditions such as obsessive-compulsive disorder (OCD) and in animal models of compulsive behavior. However, the metabolomic abnormalities present in ED have yet to be described. The purpose of this study is to perform an untargeted comparative plasma metabolomics analysis on ED patients and healthy controls to characterize the metabolic alterations in ED. Mass spectrometry quantified 76 total metabolites, 20 of which were identified as significantly different between ED and healthy controls, with four being increased and 16 being decreased in ED.