A 49-year-old man with chapped and raw hands presents to the…

A 49-year-old man with chapped and raw hands presents to the PMHNP on referral from his PCP. The man states that he washes his hands repeatedly, spending 3 to 4 hours a day washing with abrasive cleansers and very hot water. His hands hurt, but he states, “if I don’t wash this much, I will become very sick.” His PCP completed a comprehensive workup and no physical health concerns were identified. He takes no medications. What is the most likely diagnosis?