Psychotherapy for intractable inflammatory dermatoses

Most patients with inflammatory dermatoses respond to conventional treatment. Recalcitrance may indicate underlying emotional factors after infection, contact allergy, and noncompliance have been ruled out. Psychiatric treatment has been reported to be effective.

The purpose was to determine whether insight-oriented psychotherapy, by effecting last change, would provide long-term cutaneous and psychiatric improvement.

On the basis of emotional distress attributed to a recalcitrant inflammatory dermatosis, four patients were referred for psychiatric evaluation. The effect of adding insight-oriented psychotherapy as the only change in the treatment regimen of each patient was studied. Each patient served as his or her own control.

In each patient clearing of the previously recalcitrant dermatosis accompanied psychiatric improvement.

In selected cases of recalcitrant inflammatory dermatoses, insight-oriented psychotherapy may provide lasting cutaneous improvement and improved life adjustment and psychologic well-being.