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Psychodermatology: The Psychological Impact of Skin Disorders

Thomas N. Wise, M.D.

Dermatologic disorders are the most public of all maladies; thus, it is not surprising that they should cause psychological distress. Nevertheless, there is a dearth of systematic literature regarding skin diseases; thus, this short volume is indeed welcome. The book is edited by two psychologists and has contributors that include dermatologists and psychiatrists. The initial chapter focuses on psychiatric comorbidity and dermatologic disorders. The next chapter reviews stigmatization in individuals with skin disease, which is an area rarely discussed. How many adolescents have psychiatrists seen who feel both stigmatized, and are often avoided by their peers because of their terrible cystic acne? The next chapter discusses approaches to coping with chronic skin conditions. The role of dermatologic disorders in modifying relationships is given a chapter by itself, as well as the role of dermatologic disorders in children and their families. There is also a specific chapter on psychological therapies for dermatologic problems, as well as a discussion of quality-of-life issues in dermatology.

The book is well-written and well-referenced. The major deficit of the book is its only cursory attention to organic therapies. The role of isotretinoin (Accutane®) in causing decreased metabolism in the orbitofrontal cortex is only briefly mentioned. Recent data link brain-imaging studies with this decreased metabolism and isotretinoin therapy, with the concurrent possibility of mood disorder.¹ Other than this, the book is an important addition to the psychosomatic literature. Its discussion of psychological therapies, as well as its extensive reference list, make it important for any consultation–liaison psychiatrist’s library. It also should be part the library of any clinician who treats adolescents, who often have acne. The editors should consider a second edition of the book with a specific chapter on the issues of isotretinoin, as well as other organic therapies, whether they be steroids or other medications that may be associated with psychiatric symptoms.

FOOTNOTES

 
Dr. Wise is Chairman of the Dept. of Psychiatry at Inova Hospital, Fairfax, VA, and editor-in-chief emeritus of Psychosomatics.

REFERENCES

TOP REFERENCES

 

1. Bremner JD, Fani N, Ashraf A, et al: Functional brain imaging alterations in acne patients treated with isotretinoin. Am J Psychiatry 2005; 162:983–991[Abstract/Free Full Text]

Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Email this article to a Colleague Similar articles in this journal Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via Google Scholar Articles by Wise, T. N. Search for Related Content Articles by Wise, T. N. Syndromes Secondary to General Medical Disorders

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