[Scratching for the itch in eczema; a psychodermatologic approach]

Atopic dermatitis patients often complain of intense itching and excessive scratching. Apart from standard therapies of antihistamines with sedative side effects, there are patients who appear not to respond satisfactorily to standard medical treatments. As itching can be a skin manifestation of psychological disturbance, these patients may benefit from behaviour treatment of scratch behaviour which can have a beneficial effect on the course of atopic eczema. The scratch response is considered a classical conditioned habit and special attention was given to the function of behaviour. Two patients, a man of 27 and a girl of 11, were suffering from intractable atopic eczema. The first patient was required to record his own scratching in a diary which is part of awareness training regarding scratch situations. In the second patient impaired parent-child relationships were the main discriminative stimuli to provoke scratch behaviour. It was shown that behaviour therapy helps patients who scratch repeatedly to exercise voluntary control over it.