title: Current concepts in psychodermatology.
abstract: Several diagnoses in the new DSM-5 chapter on 'Obsessive-Compulsive and Related Disorders' directly relate to psychodermatology. The new excoriation (skin-picking) disorder (SPD) and trichotillomania (TTM) both manifest as recurrent body-focused repetitive behaviors that have compulsive and dissociative features, the latter being more prevalent in TTM than SPD. The DSM-5 refers to SPD and TTM occurring without full awareness or preceding tension, however does not specifically mention the possible role of dissociation. This has important treatment implications, as patients with high dissociative symptoms are not likely to respond to the standard treatments for obsessive-compulsive disorder. Body dysmorphic disorder (BDD), which is frequently associated with cutaneous body image (CBI) dissatisfaction, is present in 9%-15% of dermatology patients. Treatment guidelines in dermatology are increasingly considering the psychosocial morbidity related to CBI in their treatment outcome measures. The presence of BDD, if unrecognized, may therefore directly affect the dermatologic treatment regimens offered to the patient.
authors.affiliation: Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, 585 Springbank Drive, Suite 101, London, Ontario, N6J 1H3, Canada, magupta@uwo.ca.
authors.forename: Madhulika A
authors.initials: MA
authors.lastname: Gupta
authors.forename: Aditya K
authors.initials: AK
authors.lastname: Gupta
mesh_terms: D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D001523:Mental Disorders / Q000150:complications*; D009446:Neurobiology; D012871:Skin Diseases / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000150:complications*
references.citation: J Am Acad Dermatol. 2005 Dec;53(6):1027-37
references.pmid: 16310064
references.citation: Semin Cutan Med Surg. 2013 Jun;32(2):68-72
references.pmid: 24049962
references.citation: J Cutan Med Surg. 2013 Nov-Dec;17(6):392-7
references.pmid: 24138975
references.citation: J Clin Sleep Med. 2013 Sep 15;9(9):845-52
references.pmid: 23997695
references.citation: Clin Dermatol. 2013 Jan-Feb;31(1):72-9
references.pmid: 23245977
references.citation: J Invest Dermatol. 2004 Mar;122(3):824-9
references.pmid: 15086571
references.citation: PLoS One. 2012;7(11):e51183
references.pmid: 23226485
references.citation: Proc Natl Acad Sci U S A. 2012 Jul 31;109(31):12662-7
references.pmid: 22778400
references.citation: Clin Dermatol. 2013 Jan-Feb;31(1):66-71
references.pmid: 23245976
references.citation: J Invest Dermatol. 2008 Jul;128(7):1806-11
references.pmid: 18239615
references.citation: J Invest Dermatol. 2001 Aug;117(2):309-17
references.pmid: 11511309
references.citation: Semin Cutan Med Surg. 2013 Jun;32(2):83-7
references.pmid: 24049965
references.citation: Acta Derm Venereol. 2012 Mar;92(2):118-25
references.pmid: 22307048
references.citation: Int Rev Psychiatry. 2013 Feb;25(1):86-99
references.pmid: 23383670
references.citation: Acta Derm Venereol. 2007;87(4):295-8
references.pmid: 17598030
references.citation: Semin Cutan Med Surg. 2013 Jun;32(2):88-94
references.pmid: 24049966
references.citation: Clin Dermatol. 2013 Jan-Feb;31(1):3-10
references.pmid: 23245968
references.citation: South Med J. 2010 Dec;103(12):1199-203
references.pmid: 20978462
references.citation: Pediatr Dermatol. 2009 Mar-Apr;26(2):143-9
references.pmid: 19419459
references.citation: Sleep. 2013 Sep 01;36(9):1355-60
references.pmid: 23997369
references.citation: Sleep Med. 2012 Mar;13(3):285-9
references.pmid: 22285106
references.citation: JAMA Psychiatry. 2014 Feb;71(2):182-9
references.pmid: 24369376
references.citation: Brain Struct Funct. 2010 Jun;214(5-6):563-77
references.pmid: 20512381
references.citation: J Psychosom Res. 2013 Jul;75(1):55-9
references.pmid: 23751239
references.citation: Clin Dermatol. 2013 Jan-Feb;31(1):1-2
references.pmid: 23245967
references.citation: Semin Cutan Med Surg. 2013 Jun;32(2):110-8
references.pmid: 24049969
references.citation: Clin Dermatol. 2012 May-Jun;30(3):351-4
references.pmid: 22507051
references.citation: J Dermatol Sci. 2011 Jul;63(1):40-6
references.pmid: 21543188
references.citation: J Invest Dermatol. 2013 Feb;133(2):565-7
references.pmid: 22931920
references.citation: Depress Anxiety. 2002;15(2):83-6
references.pmid: 11891999
references.citation: Clin Dermatol. 2013 Jan-Feb;31(1):57-61
references.pmid: 23245974
references.citation: J Dermatolog Treat. 2015 Apr;26(2):193-7
references.pmid: 24511911
references.citation: J Dermatolog Treat. 2014 Apr;25(2):115-8
references.pmid: 23030461
references.citation: Compr Psychiatry. 2010 Jan-Feb;51(1):55-63
references.pmid: 19932827
references.citation: J Eur Acad Dermatol Venereol. 2012 Feb;26 Suppl 1:1-29
references.pmid: 22356611
references.citation: Semin Cutan Med Surg. 2013 Jun;32(2):101-9
references.pmid: 24049968
references.citation: Clin Dermatol. 2013 Jan-Feb;31(1):110-7
references.pmid: 23245982
references.citation: Nat Rev Neurosci. 2009 Jan;10(1):59-70
references.pmid: 19096369
references.citation: J Dtsch Dermatol Ges. 2013 Feb;11(2):125-35
references.pmid: 23176605
references.citation: Int J Dermatol. 2010 Jul;49(7):784-9
references.pmid: 20618498
references.citation: J Invest Dermatol. 1998 Jan;110(1):20-3
references.pmid: 9424081
references.citation: Semin Cutan Med Surg. 2013 Jun;32(2):95-100
references.pmid: 24049967
references.citation: Pediatr Pulmonol. 2004 Sep;38(3):210-6
references.pmid: 15274099
references.citation: J Am Acad Dermatol. 2008 May;58(5):826-50
references.pmid: 18423260
references.citation: J Am Acad Dermatol. 2009 May;60(5 Suppl):S1-50
references.pmid: 19376456
references.citation: Br J Dermatol. 2009 Nov;161(5):987-1019
references.pmid: 19857207
references.citation: Skinmed. 2013 Sep-Oct;11(5):273-80
references.pmid: 24340466
references.citation: Clin Dermatol. 2013 Jan-Feb;31(1):31-40
references.pmid: 23245971
references.citation: J Am Acad Dermatol. 2011 Jul;65(1):137-74
references.pmid: 21306785
references.citation: J Anat. 2013 Feb;222(2):161-9
references.pmid: 23078075
references.citation: Pediatrics. 2013 May;131 Suppl 3:S163-86
references.pmid: 23637225
references.citation: PLoS One. 2014 Feb 25;9(2):e89656
references.pmid: 24586942
references.citation: Clin Dermatol. 2013 Jan-Feb;31(1):62-5
references.pmid: 23245975
references.citation: Clin Dermatol. 2013 Jan-Feb;31(1):118-26
references.pmid: 23245983
references.citation: J Clin Sleep Med. 2012 Aug 15;8(4):459-60
references.pmid: 22893779
references.citation: J Psychopharmacol. 2011 Jan;25(1):17-25
references.pmid: 20093318
references.citation: Nat Neurosci. 2001 Jan;4(1):72-7
references.pmid: 11135647
references.citation: Arch Dermatol. 2011 Aug;147(8):967-70
references.pmid: 21844457
references.citation: BMJ. 2010 Dec 14;341:c6614
references.pmid: 21156746
references.citation: J Eur Acad Dermatol Venereol. 2009 Oct;23 Suppl 2:1-70
references.pmid: 19712190