Olanzapine May Be an Effective Adjunctive Therapy in the Management of Acne Excoriée: A Case Report

Abstract

Background: The self-inflicted dermatoses such as acne excoriée and neurotic excoriations are often chronic, recurring, and resistant to standard dermatologic therapies. Objective: We present a 28-year-old woman with longstanding acne excoriée, whose acne started at age 14 years and was followed by acne excoriée at age 16 years. The patient reported that her acne and self-excoriative behavior were exacerbated by psychological stress. The previously treatment-resistant acne excoriée 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 excoriée. 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 excoriée for 4 months after discontinuing the olanzapine. Conclusion: Olanzapine may prove to be a useful adjunctive therapy in some self-induced dermatoses including acne excoriée.