Psychodermatology and Psychocutaneous Disease
Psychodermatology is an emerging branch of dermatology. Patients with pyschodermatological disease are very common. They largely fall into two categories: patients with primarily psychiatric disease who present to dermatology health care professionals (e.g. delusional infestation and body dysmorphic disorder) and patients with skin disease (e.g. psoriasis, atopic eczema, vitiligo and acne) for whom there are large psychosocial co‐morbidities (e.g. anxiety and/or depression and suicide). Management of patients with psychodermatological disease requires a multidisciplinary team (MDT) approach, where possible in speicialist clinics. Such clinics are relatively rare, perceived to be expensive, but increasing globally. There is increasing evidence that management of patients with psychodermatological disease in MDT clinics is both cost effective and produces the best clinical outcome for patients. In this chapter a comprehensive list of psychodermatological disorders is covered; diagnosis, assessment and management of psychodermatological disease is discussed alongside (where possible) current theories about aetiology and psychoneurology. It is widely recognized that patients with psychodermatological disease present to dermatology health care professionals (HCPs) rather than psychiatric/psychology services. It is essential, then, that dermatology HCPs are familiar with the management of these common but complex patients, albeit with the support of a psychodermatology MDT.
Keywords psychodermatology, psychosocial co‐morbidity, delusional disorders, anxiety/depression, obsessive–compulsive spectrum disease, dermatitis, body dysmorphic disease, factitious skin disease, suicide in dermatology, psychopharmacology