Evaluation and approach to patients with psychodermatoses

Abstract

Psychodermatology is an emerging subspecialty of dermatology. It encompasses the management of patients with primary psychiatric disease presenting to dermatologists (e.g., delusional infestation, body dysmorphic disease, and factitious diseases), together with patients who have primary dermatological disease (e.g., psoriasis, atopic eczema, hair disorders, and others) with a psychiatric or psychological comorbidity. This review presents a practical approach to patients with psychocutaneous disease keeping in mind that the management requires the input of a wide multidisciplinary team including dermatologists, psychiatrists, psychologists, and primary care physicians, among others. The aim is to provide an overview on effectively building a therapeutic alliance with a psychodermatology patient in order to improve therapeutic outcomes. Dermatologists should be able to initiate basic pharmacotherapy, have a basic knowledge of nonpharmacological therapies, and be able to judge which patients need urgent psychiatric referral. Awareness of this group of disorders will enable a holistic management that takes care of body as well as the mind.

Keywords

• body dysmorphic disorder
• delusion of parasitosis
• psychocutaneous disease
• psychodermatology
• psychogenic itch
• suicide