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Somatization disorders in dermatology.

Madhulika A Gupta1

  • 1Department of Psychiatry, University of Western Ontario, London, Ontario, Canada. magupta@uwo.ca

International Review of Psychiatry (Abingdon, England)
|February 3, 2006
PubMed
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Dermatology patients often experience unexplained skin symptoms linked to psychological distress. This review covers sensory syndromes, trauma-related skin issues, and body dysmorphic disorder in dermatological care.

Area of Science:

  • Dermatology
  • Psychiatry
  • Psychosomatic Medicine

Background:

  • Somatization involves physical symptoms not fully explained by medical conditions.
  • Dermatological presentations are common in patients with somatization disorders.
  • Understanding the link between psychological factors and skin conditions is crucial for effective treatment.

Observation:

  • Review of somatization-related symptoms in dermatology.
  • Includes unexplained cutaneous sensory syndromes (dysesthesias, pain, numbness, pruritus).
  • Covers trauma-related symptoms (post-traumatic stress disorder) manifesting as skin conditions like urticaria, angioedema, and exacerbations of psoriasis and atopic eczema.
  • Addresses dissociative symptoms (loss of touch/pain) and self-induced dermatoses (dermatitis artefacta, trichotillomania).
  • Discusses body dysmorphic disorder with somatic preoccupation involving skin or hair.

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Findings:

  • Cutaneous dysesthesias, pruritus, urticaria, and angioedema can be linked to psychological distress and trauma.
  • Autonomic hyperarousal in post-traumatic stress disorder can trigger or worsen stress-reactive dermatoses.
  • Dissociative states are associated with 'pseudoneurologic' symptoms and self-induced skin conditions.
  • Body dysmorphic disorder presents as a somatic preoccupation with the skin or hair.

Implications:

  • Highlights the need for integrated dermatological and psychological care.
  • Emphasizes recognizing somatization to improve diagnostic accuracy and patient outcomes.
  • Suggests that addressing underlying psychological factors can alleviate dermatological symptoms.