Practical Psychodermatology

Skin disease can be more than skin deep Our skin is one of the first things people notice about us. Blemishes, rashes, dry, flaky skin – all these can breed insecurity, even suicidality, even though the basic skin condition is relatively benign. Skin disease can lead to psychiatric disturbance. But symptoms of skin disease can also indicate psychological disturbance. Scratching, scarring, bleeding, rashes. These skin disturbances can be the result of psychiatric disease. How do you help a dermatological patient with a psychological reaction? How do you differentiate psychological causes from true skin disease? These are challenges that ask dermatologists, psychiatrists, psychologists and other health care specialists to collaborate. Practical Psychodermatology provides a simple, comprehensive, practical and up–to–date guide for the management of patients with psychocutaneous disease. Edited by dermatologists and psychiatrists to ensure it as relevant to both specialties it covers: History and examination Assessment and risk management Psychiatric aspects of dermatological disease Dermatological aspects of psychiatric disease Management and treatment The international and multi–specialty approach of Practical Psychodermatology provides a unique toolkit for dermatologists, psychiatrists, psychologists and other health care specialists needing to care for patients whose suffering is more than skin deep.

Contributors, vii Foreword, xi Preface, xiii Section 1: Introduction 1 Introduction, 3 Anthony Bewley, Michelle Magid, Jason S. Reichenberg and Ruth E. Taylor 2 History and examination, 11 Ruth E. Taylor, Jason S. Reichenberg, Michelle Magid and Anthony Bewley Section 2: Management in psychodermatology 3 Psychopharmacology in psychodermatology, 21 Sussann Kotara, Michelle Magid and Maureen Burrows 4 Adherence in the treatment of chronic skin diseases, 33 Laura F. Sandoval, Christine S. Ahn and Steven R. Feldman 5 Psychological assessment and interventions for people with skin disease, 40 Reena B. Shah 6 Risk and risk management in psychodermatology, 50 William H. Reid and Simon Kirwin 7 Self–help for management of psychological distress associated with skin conditions, 60 Andrew R. Thompson 8 Habit reversal therapy: a behavioural approach to atopic eczema and other skin conditions, 66 Christopher Bridgett 9 Nursing interventions in psychodermatology, 72 Fiona Cowdell and Steven Ersser Section 3: Skin diseases with secondary psychiatric disorders 10 Psychological impact of hair loss, 81 Paul Farrant and Sue McHale 11 Psoriasis and psychodermatology, 90 Christine Bundy, Lis Cordingley and Chris Griffi ths 12 Living well with a skin condition: what it takes, 97 Henrietta Spalding, Wendy Eastwood, Krysia Saul and Susan Bradbrooke 13 Chronic skin disease and anxiety, depression and other affective disorders, 104 Steven Reid and Wojtek Wojcik Section 4: Psychiatric disorders with secondary skin manifestations 14 Delusional infestation, 117 Peter Lepping, Roland Freudenmann and Markus Huber 15 Body dysmorphic disorder, 127 Emma Baldock and David Veale 16 Pickers, pokers, and pullers: obsessive–compulsive and related disorders in dermatology, 134 Jonathan S. Abramowitz and Ryan J. Jacoby 17 Factitious skin disorder (dermatitis artefacta), 142 Jonathan Millard and Leslie Millard Section 5: Cutaneous sensory (pain) disorders 18 Medically unexplained symptoms and health anxieties: somatic symptom and related disorders, 153 Angharad Ruttley, Audrey Ng and Anna Burnside 19 Dysesthetic syndromes, 164 Sara A. Hylwa, Mark D.P. Davis and Mark R. Pittelkow 20 Chronic idiopathic mucocutaneous pain syndromes: vulvodynia, penodynia, and scrotodynia, 173 Peter J. Lynch and Libby Edwards 21 Burning mouth syndrome, 180 Alison Bruce, Rochelle R. Torgerson, Cooper C. Wriston and Tania M. Gonzalez Santiago 22 Nodular prurigo, 186 Wei Sheng Tan, Hong Liang Tey and Mark B.Y. Tang Section 6: Special populations and situations 23 Child and adolescent psychodermatology, 197 Birgit Westphal and Osman Malik 24 Psychodermato–oncology: psychological reactions to skin cancer, 206 Andrew G. Affleck and Lesley Howells 25 Botulinum toxin treatment in depression, 216 M. Axel Wollmer, Michelle Magid and Tillmann H.C. Kruger 26 The Morgellons debate, 220 Jason S. Reichenberg and Michelle Magid 27 Substance misuse and the dermatology patient, 224 Alexander Verner Glossary, 231 Appendix: Screening questionnaires and scales, 238 Index, 268

Edited by Anthony Bewley , MB, ChB, FRCP, Department of Dermatology, The Royal London Hospital & Whipps Cross University Hospital (Barts Health NHS Trust), London, UK Ruth Taylor , MB ChB, MRCPsych, PhD, Department of Psychiatry, Barts and the London School of Medicine and Dentistry, London, UK Jason S Reichenberg , MD, Department of Dermatology, University of Texas Southwestern, Austin, TX, USA Michelle Majid , MD, Department of Psychiatry, University of Southwestern, Austin, TX, USA