A woman with dermatitis and dissociative periods

A nineteen year old female with pustular eczema and dissociative spells is presented. The patient has a three year history of severe dermatitis beginning shortly after her marriage. Central dynamic issues appear to be difficulty separating from her mother and an ambivalent identification with a hostile father. The patient also describes fugue-like episodes which occur with emerging aggressive feelings. Psychological testing supported these hypotheses. The relevant literature describing the correlation between aggression and skin disease is reviewed. A final uniform formulation was tentatively proposed that this patient, in addition to a strong genetic component for atopic dermatitis, had her illness abetted by inability to cope with aggressive affects.