dermato & psycho 2018

1. PSYCHOLOGICAL ASPECTS OF SKIN
DISEASES
Haneen Ayad

2. POSSIBLE PSYCHOLOGICAL CONSEQUENCES OF
SKIN
disease include:
Effects on:
• Self esteem
• Body image
• Relationships
• Quality of life
that can all contribute to psychological
disturbance
and/or psychiatric illness

3. PSYCHOLOGICAL CONSEQUENCES DEPEND
UPON:
• Nature of skin disease:
– severity
– Course: acute, progressive or episodic
– Cause: congenital or acquired (stage in life)
– Location, size, characteristics etc
• Personality traits
• Social factors
– relationships
– work, hobbies etc
– culturalexpectations

4. SKIN MANIFESTATIONS OF PSYCHIATRIC
DISEASE
• Deliberate self harm
• Dermatitis artefacta
• Parasitosis
• Dysmorphophobia
• Trichotillomania
• Excessive handwashing, neurotic excoriations
• Signs of alcohol and substance misuse
• Sun sensitivity
• Nicotine stained fingers

5. TRICHOTILLOMANIA
•
Trichotillomania (TTM) is characterized by the
recurrent pulling out of one’s hair resulting in
noticeable hair loss
from scalp, eyebrows or other areas of body,
despite trying to stop
_ when treat the mental condition will appear
the hair again
cognitive–behavioral therapy ,supportive therapy
and medication

7. DERMATITIS ARTEFACTA
Clinical pic :
• Dramatic lesions, calm manner, thick notes
• Not characteristic of known dermatoses
• In reach of patient’s hands
• Lesions appear fully formed all at same
stage
of development
• ‘hollow history’: inability to elicit evidence of
evolutionary changes

9. DYSMORPHOPHOBIA
Primary complaint of some external physical
defect thought to be noticeable to other
people,
but, objectively, appearance lying within
normal
Cosmetic surgery

11. OBSESSIVE COMPULSIVE DISORDER
_Compulsive hand-washing
severe skin scraping and abrasion, obsessive
haemorrhage, biting of nails
_Overzealous cleaning
People with OCD who fall into the "washers"
category also tend to clean compulsively
That irritation of skin and Inflammation due to the
use of detergents

13. SKIN CONDITIONS CAUSED BY DRUG TREATMENT OF
PSYCHIATRIC DISEASE :
• Lithium : acne
• Isotretinoin :burning or stinging of the skin •
Chlorpromazine: more sensitive to sunlight
• Steroids
Perioral dermatitis ,Steroid rosacea
Hypopigmentation , telangiectasia , acne
Contact allergy,atrophy ,
• Lamotrigine : skin rash

14. • LITHIUM : ACNE (BIPOLAR )

15. • ISOTRETINOIN :BURNING OR STINGING OF
THE SKIN (DEPRESSION )

16. CHLORPROMAZINE: MORE SENSITIVE TO
SUNLIGHT (ANTIPSYCHOTIC)

17. • STEROIDS
PERIORAL DERMATITIS ,STEROID ROSACEA
HYPOPIGMENTATION , TELANGIECTASIA , ACNE
CONTACT ALLERGY,ATROPHY ,

18. • LAMOTRIGINE : SKIN RASH
(DEPRESSION )