Psychosomatic skin diseases
Psychiatric aspects of dermatological practice
Psychosomatic skin diseases are not uncommon and account for 14-18% of all dermatoses. In 21% of patients in psychotherapeutic hospitals, manifestations of skin symptoms occur. According to many researchers, the frequency of emotional factors among other causes of skin pathology is 25-50%, and effective treatment of almost 40% of dermatological patients is impossible if the role of the psychological component in the development of dermatosis is ignored.
Svetlana Galnykina, Doctor of Medical Sciences, Professor of Ternopil National Medical University named after I. Ya. Gorbachevsky, Clinic of Dermatology and Cosmetology Art Clinique (Ternopil)
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The common embryonic origin of the skin and the central nervous system is a sufficient basis for predicting the relationship of these systems.
Despite the fact that the condition of the skin is always available for self-observation, the mental reactions of patients are constantly stimulated. In patients with chronic dermatoses, frequent neuroses and neurotic syndromes are observed, manifested by irritability, frequent mood swings, tearfulness, and unpleasant sensations in the region of various organs. Even a slight deterioration in the condition of the skin in dermatological patients, especially when exposed areas are affected, is reflected in the psyche, and this leads to an unfavorable course of dermatoses.
People suffering from chronic dermatoses often experience the fact that others may avoid them for fear of getting infected, which is a factor that traumatizes their psyche, complicating the recovery process. People who surround the patient should be explained that these patients are not contagious. This issue is especially relevant in children's groups.
In dermatological practice, artifacts are increasingly common. There are such types of them:
- dermatomania - trichotilomania (hair pulling), onychophagia (nail biting), neurotic excoriations;
- mutilation - simulation (damage to intact skin for the purpose of some benefit), aggravation, pathomymia;
- psychopathy (self-injury of the skin in mentally ill patients) - applying various irritants to the skin and other damage.
The main thing in the diagnostic process (including in the cosmetologist's office, who for some reason suspects the «artificial» origin of such manifestations) is clinical observation, anamnesis, observation of the patient's behavior, differential diagnosis with idiopathic skin diseases. The correct diagnosis is also confirmed by the positive results of treatment with the use of psychotropic drugs, hypnosis, as well as means that prevent injury (zinc-gelatin dressings, shaving the head, applying adhesive bandages, etc.).
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