THE IMPORTANCE OF DUAL DERMATOLOGIC AND PSYCHIATRIC APPROACH IN PSYCHOCUTANEOUS DISORDERS

Abstract

Psychodermatology or psychocutaneous medicine is a relatively old domain, built on well studied and documented connections between mental / psychic and skin. Numerous studies highlight the idea that evolution of a significant percentage of dermatoses is negatively influenced by psychological factors and stress and that mental state affects not only how the disease is perceived but its severity as well. It is estimated that 30-40% of dermatological patients show a concurrent mental disorder or psychological problems that may be the causative, predisposing or aggravating factor of the cutaneous disease. Morbid conditions such as psoriasis, atopic dermatitis, alopecia areata, vitiligo, severe acne have a marked negative impact on patient quality of life through both debilitating and chronic character of the diseases and by their psychosocial consequences: decreased self-esteem, embarrassment, depression, social phobia, social discrimination to employment, family and couple relations alteration. Collaboration with a psychiatrist for optimal management of psihocutaneous disorders is essential but difficult to acheive because most patients with such morbidity refuse (do not accept) the referral to psychiatric/psychologic consultation. Therefore the dermatologists need to have knowledge on pharmacological and non-pharmacological means useful in treating these disorders and to reconsider the importance of training in the field of psihodermatology. Cutaneous side effects of psychotropic drugs must also be known because they are more frequently encountered than most common psychiatric side effects of drugs used in dermatology