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Psychocutaneous Diseases

»How do the fields of psychiatry and dermatology overlap?
»What types of psychocutaneous disease are encountered in dermatology?
»How often do patients with dermatologic disorders have associated psychologic morbidity?
»What is the differential diagnosis of patients who complain that they are infested with parasites?
»Define obsession or compulsion, phobia, delusion, and hallucination.
»What is “delusions of parasitosis”?
»How do you diagnose this disorder?
»How do you treat this problem?
»What are the major side effects of pimozide?
»What if the patient is noncompliant with pimozide treatment?
»What is Ekbom syndrome?
»What is dysmorphophobia?
»Name the three major categories of self-inflicted skin lesions. What differentiates them?
»What are the clinical manifestations of dermatitis artefacta?
»How should patients with dermatitis artefacta be treated?
»What is the Gardner-Diamond syndrome?
»How do Munchausen syndrome and Munchausen syndrome by proxy differ?
»What is the differential diagnosis of patchy nonscarring alopecia?
»What is the psychiatric diagnosis associated with trichotillomania?
»How do you differentiate among the different forms of nonscarring alopecia?
»Can a biopsy help in the differential diagnosis of patchy nonscarring alopecia?
»What is trichotemnomania?
»What are neurotic excoriations?
»How do you treat this disorder?
»What are the side effects of fluoxetine?
»What is glossodynia?
»Name some primary dermatologic disorders that might result in secondary psychiatric problems. What sorts of problems might these patients have?
»Can stress exacerbate a primary dermatologic disorder?

 
 
 

How do the fields of psychiatry and dermatology overlap?

Many studies confirm that a high percentage of dermatology patients have coexistent psychiatric morbidity. Our understanding of this phenomenon remains limited. We do know that the skin and nervous system have the same embryologic origin, and that tactile stimulation is critical for full neuropsychological development, but many questions remain. Recent biomedical advances have begun to take psychocutaneous disease out of the realm of speculation and myth.

As we examine shared symptom complexes and responses to pharmacologic intervention, many psychocutaneous disorders can now be thought of in terms of neurotransmitters and their receptors, with all the inherent implications for treatment. This does not negate a role for various modalities of psychotherapy. Instead, our deeper understanding of psychocutaneous disease can only lead to improved patient care.