A Psychodermatology Clinic

The Concept, the Format, and Our Observations From Israel

Edith Orion; Benjamin Feldman; Wolf Ronni; Ben-Avi Orit

Am J Clin Dermatol. 2012;13(2):97-101.

Abstract and Introduction

Abstract

The connection between the brain and the skin is more than a physiologic fact. Skin conditions can impose great effects on every field in the patients' lives. Reciprocally, skin diseases can be evoked by psychological problems. A psychodermatology clinic is the format that enables dermatology patients to receive a comprehensive approach to their skin condition as well as to the difficulties it imposes on their lives, and vice versa. Although the notion that skin and mind are connected and have bilateral influences that should be addressed is now appreciated, it is surprising that such clinics are not more prevalent. In the literature there are only a few descriptions of such clinics, and even fewer descriptions of their format and their working formulations with their pluses and minuses.
In this article, we describe in detail the working formulation of a new psychodermatology clinic in Israel, as well as our therapeutic methods, data, conclusions, and observations after the first 3 years.
During a 3-year period, 124 patients were seen in our psychodermatology clinic, presenting with a vast array of dermatologic complaints. One of our major observations was that lack of proper patient-doctor communication resulted in the development of misconceptions about the disease, low compliance, and even long-lasting psychological difficulties. Another important observation was that there is a true need for such a clinic, among patients as well as among their doctors.

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Next Section

Abstract and Introduction
1. Psychodermatology – Terra Incognita
2. The Concept of a Psychodermatology Clinic
3. The Concept of Our Clinic
4. The Intake Consultation
5. Advantages of this Structure
6. Difficulties Encountered
7. Preliminary Data
8. Conclusions
References

Table I. The distribution of the dermatologic diagnoses of patients referred to the psychodermatology clinic
Dermatologic diagnoses of patients	Number of patients
Pruritus – neurotic excoriations	48
Psoriasis	27
Atopic dermatitis	9
Hair loss	6
Vitiligo	5
Burning sensations	5
Delusional parasitosis	5
Seborrheic dermatitis	4
Lichen simplex chronicus	4
Chronic urticaria	3
Self-inflicted lesions	3
Nonspecific dermatitis	3
Dyshidrotic eczema	2
Post-herpetic neuralgia	1
Acne	1
Mycosis fungoides	1
Oily skin	1
Trichotillomania	1
Neurofibromatosis	1

Table II. The array of psychological/psychiatric therapies suggested to the patients
Therapy suggested	Remarks
Psychotherapy (long-/short-term dynamic therapy, narrative therapy, etc.)	In our psychodermatology clinic, in our hospital psychiatric outpatient unit, or in the patient's residential vicinity
Cognitive behavioral therapy	In our psychodermatology clinic or in the patient's residential vicinity
Hypnotherapy, guided imagery, relaxation techniques	In our psychodermatology clinic or in the patient's residential vicinity
Parents therapy, parents guidance (in cases where the patient is a child)	In our psychodermatology clinic
Family therapy, couples therapy	In our psychodermatology clinic or in the patient's residential vicinity
Psychopharmacologic therapy	In our psychodermatology clinic, in our hospital psychiatric outpatient unit, or in the patient's residential vicinity
Art therapy	In the patient's residential vicinity

Table III. The distribution of dermatologic diagnoses of elderly patients (aged over 70 years) referred to the psychodermatology clinic
Diagnoses of patients aged over 70 years	Number of patients
Neurotic excoriations	4
Nonspecific dermatoses	1
Burning sensations	3
Pruritus	4
Hair loss	1
Psoriasis	1
Prurigo nodularis	1
Delusional parasitosis	1

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A Psychodermatology Clinic

The Concept, the Format, and Our Observations From Israel

Abstract and Introduction

Abstract

Tables

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

Comments

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