What he does to himself might be harmless. If he can force others to accept his delusion and punish them if he isn't treated as a dragon then it's a serious problem.What I find heartbreaking is that apparently there is nobody in this guy's life to notice he is out of control and stopped him. I hope someone at least tried. He may not be hurting anyone else but dang if he isn't hurting himself.
Seriously. Dude, You are not a lizard. To cut off your penis, have scales tattooed on your skin, have your tongue slit in half, put on fake nails, dye your eyeballs green, and cut off your ears, is a pretty clear indication that you don't have a grip on reality.