Psychodermatological disorders

The skin is the largest organ of the body covering a surface area of 1.5 to 2 square metres in the average adult. It plays a vital role in the interface with external elements and because of its visibility has tremendous social significance. The skin and the nervous system share a common embryonic origin from the ectoderm and hence pathology in one organ system is likely to affect the other.

The purpose of this module is to alert the clinician to potentially treatable psychiatric disorders that may underlie some dermatological disorders and to review the salient clinical features and psychiatric treatments that have been reported to be effective.

It is estimated that approximately one third of dermatology patients have some type of associated psychiatric or psychological problem. Effective management involves an integrated approach to the patient, including consideration of associated emotional factors (Gupta et al, 1996).

Psychiatric intervention is often the most crucial element in the treatment of these patients. However, many of these patients lack insight into the possible psychogenic origin of their symptoms and are often reluctant to accept a psychiatric referral.