Olanzapine may be an effective and adjunctive therapy in the management of Acne excoriee:: A case report

Background: The self-inflicted dermatoses such as acne excoriee and neurotic excoriations are often chronic, recurring, and resistant to standard dermatologic therapies. Objective: We present a 28-year-old woman with longstanding acne excoriee, whose acne started at age 14 years and was followed by dime excoriee at age 16 years. The patient reported that her acne and self-excoriative behavior were exacerbated by psychological stress. The previously treatment-resistant acne excoriee responded favorably to treatment with the atypical antipsychotic agent olanzapine. Methods: The patient was started on olanzapine 2.5 mg at bedtime. Results: After 4 weeks of therapy with olanzapine she reported a significant decline in her self-excoriative behavior which was associated with an improvement in her acne excoriee The patient used the olanzapine 2.5 mg for 6 months, during which time she also entered psychotherapy in order to deal with some psychosocial stressors that were exacerbating her self-excoriative behavior. The patient has not experienced a recurrence in her self-excoriative behavior or acne excoriee for 4 months after discontinuing the olanzapine. Conclusion: Olanzapine may prove to be a useful adjunctive therapy in some self-induced dermatoses including acne excoriee.