Primary psychiatric conditions: dermatitis artefacta, trichotillomania and neurotic excoriations.
Primary psychiatric conditions encountered in dermatology include dermatitis artefacta, trichotillomania (TTM) and neurotic excoriations. For these disorders, the primary pathologic condition involves the psyche; therefore, any cutaneous findings are self-induced. Herein, we review common primary psychiatric conditions in dermatology - dermatitis artefacta, neurotic excoriations and TTM - and examine their epidemiology, clinical presentation, differential diagnosis and treatment strategies. For all primary psychiatric disorders, the most effective underlying strategy is to first establish a strong therapeutic rapport with the patient. Various pharmacologic and non-pharmacologic therapies can then be attempted afterwards to successfully manage these patients.
School of Medicine, University of Utah, Salt Lake City, UT, San Francisco, California ; Department of Dermatology, University of California, San Francisco, California, USA.
Jillian W
JW
Wong
Tien V
TV
Nguyen
John Ym
JY
Koo
Dermatitis artefacta; neurotic excoriations; primary psychiatric disorder; psychodermatology; trichotillomania