Dermatopsychosomatics: classification, physiology, and therapeutic approaches

Psychosomatic dermatology is practiced in some manner by every dermatologist. In spite of this, there has been a virtual void in the literature from the middle 1950s until the present time. The relationship to physiologic phenomena, as well as a classification of psychosomatic dermatology, is reviewed. Dermatologic patients are divided into three groups: the primary group in which the emotional disorder is the primary disease and the cutaneous disorder merely part of its expression; the secondary group in which the basic cause is organic but does not affect the person emotionally in various degrees; and the collaborative group in which the organic causes and emotional disorders combine in different degrees to cause the skin disorder. This paper discusses anxiety and depression along with methods of dermatologic psychosomatic therapy consisting of antianxiety drugs, especially the benzodiazepines, antidepressants, hypnosis, behavior therapy, and the doctor/patient rapport. We conclude that one of the objectives for every dermatologist is to treat the entire patient-the psyche along with the soma.