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A 32-year-old female with no significant past medical history presents with a complaint of "bad acne for the past 3 months." She is especially troubled because she reports never having a problem with her skin before. The physical exam reveals many excoriations, but there are no primary acneiform lesions present. She admits to picking at her skin and reports no history of mental health issues. She does, however, express a great deal of concern about the state of her marriage, which she describes as "on the rocks." What are the patient's diagnosis and likely prognosis?

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