level with 88% of participants identified through the DISP as meeting DSM-5 criteria. Additionally, researchers conducted a 5-month period of validity to determine consistency with the scale. The data shows clinicians can expect to yield consistent data with administration of the scale ranging from satisfactory to perfect levels of diagnosis. However, a review of the scientific literature by Jenkins et al. on excoriation disorder as a separate category in the DSM-5 concluded that such a distinction requires more evidence. Because excoriation disorder is different from other conditions and disorders that cause picking of the skin, any diagnosis of excoriation disorder must take into account various other medical conditions as possible causes before diagnosing the patient with excoriation disorder. There are a variety of conditions that cause itching and skin picking including: eczema, psoriasis, diabetes, liver disease, Hodgkin's disease, polycythemia vera, systemic lupus, and Prader–Willi syndrome. In order to better understand excoriation disorder, researchers have developed a variety of scales to categorize skin-picking behavior. These include the Skin-Picking Impact Scale (SPIS), and The Milwaukee Inventory for the Dimensions of Adult Skin-picking. The SPIS was created to measure how skin picking affects the individual socially, behaviorally, and emotionally. As of the release of the fifth Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013, this disorder is classified as its own separate condition under "Obsessive Compulsive and Related Disorders" and is termed "excoriation (skin-picking) disorder". The diagnostic material is as follows: Repeated picking of the skin, resulting in injuries Recurring attempts to stop picking while relapses continually occur Picking causes a substantial amount of distress and substantially impairs everyday functioning The picking is not caused or cannot be better explained by physiological effects of a substance or a medical disorder The picking is not more accurately attributed to another mental disorder Classification Since the DSM-5 (2013), excoriation disorder is classified as "L98.1 Excoriation (skin-picking) disorder" in ICD-10; and is no longer classified in "Impulse control disorder" (f63). Excoriation disorder is defined as "repetitive and compulsive picking of skin which results in tissue damage". Its most official name had been "dermatillomania" for some time. As of the release of the DSM-5 in May 2013, excoriation disorder is classified as its own separate condition under "Obsessive Compulsive and Related Disorders" and is termed "excoriation (skin-picking) disorder". Similarities with other conditions The inability to control the urge to pick is similar to the