Dermatitis artifacta is a skin problem that is hard to diagnose and even harder to treat as it involves the compulsion to pick at the skin or otherwise damage the skin, often as a coping mechanism that the patient refuses to acknowledge.
Symptoms of Dermatitis Artifacta
This behaviour creates a diverse array of signs on the skin, varying in shape, size and nature and causing considerable confusion amongst clinicians and dermatologists until the psychological aspect of the skin disorder is identified. Confronting a patient about the disorder may simply cause them to retreat and seek help elsewhere, meaning that the physician has to tread carefully before broaching the mental health component of the disease.
Psychological Skin Disorders
In a recent study carried out in Boston, a large proportion of dermatologists reported a lack of confidence in adequately treating skin disorders with a psychological component, such as delusional parasitosis and dermatitis artifacta. Working closely with a psychiatrist familiar with such skin disorders may be the best option for long-term patient care with Fried (2002) calling for dermatologists to refer patients to a skin emotion specialist for treatment.
Dermatologists may also want to take heed of a Japanese study published this month that looked at the personality traits of patients with psoriasis and atopic dermatitis, compared to healthy controls.