A person's boundaries: a meaning of skin disease

This report attempts to broaden understanding of the psychological meaning of skin disease by describing patients' fantasies of healthy vs diseased skin. All disease states have emotional concomitants in ideas, attitudes, and fantasies--much at variance with what the clinician views in an "objective" focus. Skin disease particularly is invested with affectively charged ideas. The issue of "dirt" contained, in fantasy, by healthy skin is explored. Skin lesions are particularly difficult for many patients to master emotionally, because such lesions engender a sense of dirtiness--a feeling of lack of control over body contents.