Dermatitis artefacta as a symptom of schizophrenia? (original) (raw)

The prevalence of skin disorders in patients with schizophrenia

2023

There is ample evidence suggesting the presence of various multisystemic comorbidities in patients with schizophrenia. However, data on dermatological comorbidities in these patients are scarce. The present study aimed to analyze the profile of cutaneous conditions in patients with schizophrenia and contribute to the existing evidence in this area. A total of 102 consecutive adult patients with schizophrenia, who were attending the follow-up service at the outpatient clinic of the Department of Psychiatry in a tertiary hospital in North India, were evaluated by a dermatologist for the presence of any skin disorder. Dermatological findings were noted in 70% of patients and 38% had multiple skin conditions. Infections were the most prevalent diagnosis, with fungal infections being commonly observed. Other common dermatoses included nevi, age-related cutaneous changes, dyschromia, and drug-induced acne. The present study concluded that there is a high prevalence of dermatological diseases in patients with schizophrenia. Caregivers and psychiatrists managing these patients should familiarize themselves with these conditions, and dermatology consultation should be sought for prompt diagnosis and management.

A STUDY OF CUTANEOUS MANIFESTATIONS OF PATIENTS WITH PSYCHIATRIC DISORDER

Skin is an organ that has a primary function of tactile receptivity and reacts to both external and internal emotional stimuli. Dermatological practice certainly embeds a psychosomatic dimension. A relationship between psychological factors and skin diseases has long been hypothesized. AIMS AND OBJECTIVES The aim of present study is to evaluate the prevalence of cutaneous manifestations in patients with psychiatric disorder. MATERIALS AND METHODS Twenty five psychiatric in-patients admitted in the psychiatry ward of a Tertiary Care Hospital were examined for the presence of cutaneous manifestation over a period of 6 months. Appropriate laboratory investigations such as scraping for Acarus, skin biopsy etc. were performed wherever required. The observations were noted. RESULTS The commonest cutaneous manifestations seen in this study were (i) Parasitic infestations like scabies (20%), pediculosis capitis (16%), (ii) Xerosis (28 %), (iii) Prurigo nodularis (4%), (iv) Lichen simplex chronicus (4%), (v) Venereophobia (4%) and (vi) Delusion of parasitosis (4%). CONCLUSION A high incidence of parasitic infestations was noted in our study. The healthcare personnel should be sensitized on the significance of such parasitic infestations in institutionalized patients and the importance of early detection and treatment.

Dermatoglyphics in patients with schizophrenia - findings in the macedonian population

Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences, 2013

The human palms and soles are textured with skin different to that of the other body surface. Instead of sebaceous glands or hairs, there are sweat glands opening into epidermal ridges. They are variously oriented, thus forming different patterns. The aim of the study was to assess some dermatoglyphic patterns, the TRC and the a-b ridge count in a sample of patients and a control group of healthy examinees. Material and method: 59 male and 50 female patients with schizophrenia and 60 healthy male and 50 female individuals as a control group were included in the study. Hand prints were taken using the method of Cummins and Midlo; pattern types were determined and classified using the Henry classification. An analysis of pattern frequency in schizophrenia compared to the normal controls was conducted. Results: The patterns most frequently present are loops (ulnar) with greater incidence and whorls with smaller incidence in patients with schizophrenia compared to the healthy individuals. The number of arches is higher in male patients and lower in female patients. Complex patterns are rare. TRC in females has lower values found in patients. The a-b ridge count has significant difference in male and female patients; higher values in male and lower in female patients. Conclusion: There is some association between the frequency of certain dermatoglyphic characteristicss and schizophrenia. Our findings form a useful database for the dermatoglyphic marks present in patients with schizophrenia and healthy subjects of Macedonian nationality.

A study of skin manifestations in patients with psychiatric disorders

International Journal of Research in Dermatology

Background: The interaction between psychological factors and skin diseases has long been hypothesized. Considerations of psychiatry and psychosocial factors are important for better management of dermatological disorders as coexistence of psychiatric and dermatological disorders are mostly seen. The aim of the study was to identify skin manifestations in individuals suffering from psychiatric disorders.Methods: A total of 100 patients attending dermatology OPD were screened for history of any psychiatric illness and patients with a positive history of psychiatric illness were recruited into study. The skin lesions were categorised as per the classification of psychodermatology and results were analysed accordingly.Results: The patients recruited belonged to age groups ranging from 12 to 70 with a higher female to male ratio (54% females and 46% males). The psychophysiological disorders constituted 29 %, among them chronic urticaria (34.4%) followed by psoriasis (27.58%) constituted...

A study of skin disorders in patients with primary psychiatric conditions

Indian journal of dermatology, venereology and leprology

The skin occupies a powerful position as an organ of communication and plays an important role in socialization throughout life. The interface between dermatology and psychiatry is complex and of clinical importance. To document the incidence of cutaneous disorders in patients with primary psychiatric conditions. Three hundred patients with a primary psychiatric condition who had cutaneous disease were entered into the study group. The patients were classified appropriately based on the classification of psychocutaneous disorders. The control group included 300 patients presenting with a skin disorder and without any known psychiatric complaint. The majority of the cases in the study group were in the 3rd-5th decade. In this study, the most common primary psychiatric conditions were manic depressive psychosis (53.33%), depression (36.33%), schizophrenia (8.33%) and anxiety (2%). Of the study group, 68.66% patients had infective dermatoses and the rest had non-infective dermatoses. A...

The self-inflicted dermatoses: A critical review

General Hospital Psychiatry, 1987

The self-inflicted dermatoses, namely dermatitis artefacta, neurotic excoriations, and trichotillomania, have been reported to be associated with various degrees of psychopathology in the dermatologic literature, but have received surprisingly little emphasis in the psychiatric literature. This probably reflects, firstly the fact that most of these patients initially deny any psychologic problems and hence may not receive psychiatric interventions, and secondly a lack of adequate collaboration between the psychiatrist and dermatologist. These disorders may be associated with serious sequelae, such as suicide and repeated major surgical procedures. Their treatment is also primarily psychiatric. This article critically reviews the literature and comments upon the salient clinical features and treatments for these disorders, which are relevant for the psychiatrist doing consultation-liaison work. Knowledge of these disorders is important in theevaluation ofanypsychiatricpatient. as these disorders are essentially a cutaneous sign of psychopathology.

Case series of primary psychiatric skin disorders with multi-disciplinary approach

Journal of General - Procedural Dermatology & Venereology Indonesia, 2020

Background: The incidence of psychodermatologic diseases, a group of skin abnormalities associated with psychosomatic factor, are increasing recently. About 20-40% patients with skin symptoms have concurrent psychiatric problems which are often difficult to diagnose and treat. The new classification of primary psychiatric skin disorders are delusional disorders, obsessive-compulsive and related disorders, and factitious disorders. This classification could be used for effective treatment in each patient which involves multidisciplinary approach, including dermatology, psychiatry and other discipline if necessary. Case Illustration: The first case was a 39-year-old unmarried female, with anemia and dermatitis artefacta occurred as wound due to blade cuts. Patient was with schizoaffective depressive type and was not under regular treatment. The second case was a 61-year-old male referred with unresolved prurigo nodularis for the past 30 years. After in-depth assessment, there were delusional parasitosis and neurotic excoriations disorders. The third patient was a 50-year-old female admitted with recurrent ulcer on her face. She was aware that the lesions were intentionally manipulated by her own fingers when she was depressed. Discussion: All patients were classified as primary psychiatric skin disorders with varied skin manifestations. Symptoms usually occurred when the patient was in the depression state or low compliance for the psychotropic drugs. Patients generally had poor insight and refused to be associated with psychiatric factors. Dermato-venereologists are expected to conduct early detection and treat this disease. Conclusion: It is important to approach psychocutaneous disease in multidisciplinary manner, especially with the psychiatrist.

CUTANEOUS PATHOMIMIA IN ADULTS: A SIGN OF PSYCHIATRIC ILLNESS.

Psychocutaneous disorders are conditions characterized by psychiatric and skin manifestations, they are difficult to diagnose and a challenge to treat. Pathomimia is manifested by self-induced skin lesions, in order to attract more attention of the relatives and/or the medical staff. Depression and anxiety are the two most frequent psychiatric disorders among factitious disorders patients. Cooperation between dermatologists and psychiatrists, lead to significant improvement of those conditions. We report the case of a 67-year-old female with unknown psychiatric history and self-induced skin lesions of the lower limbs.