By Gary M. White, MD
The picker's nodule is common in the scalp. Very short hairs growing out of the lichenified papule are typical.
The picker's nodule is exactly that--a nodule (or papule) that forms from chronic picking. For related conditions, see prurigo nodularis, lichen simplex chronicus, and factitial.
A 4-8 mm, hyperkeratotic papulonodule with multiple short hairs in the scalp is typical. The nape or posterior scalp is most commonly affected. The patient readily admits to chronic picking or scratching.
The condition is harmless, but may lead to permanent alopecia over time. The patient should be educated in the cause (chronic picking) and encouraged to cease. A potent topical steroid may be given BID.
See lichen simplex chronicus.
An unusually big nodule with possibly keloid formation.
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