Skin disorders in patients with primary psychiatric conditions
Keywords:
Psychiatric patients, skin disordersAbstract
Objective To determine the frequency of skin dermatosis in patients with primary psychiatric conditions.Methods This cross-sectional study was conducted in the Fountain House, Lahore, which is a tertiary care center for psychiatric patients having indoor and outdoor facility. All the admitted psychiatric patients (294) were enrolled in the study. They were thoroughly examined for any skin dermatosis. Out of 294, skin disorders were seen in 172 (58.5%) patients, 89 (60.6%) males and 58 (39.4%) females. The most common primary psychiatric conditions was schizophrenia 47.5% followed by patients of substance abuse 26.5%, bipolar disorder 13.1%, depression and psychosis each in 8.2%. 2.7% patients were manic. Of the study group, 16.3% patients had infective dermatoses and the rest had noninfective dermatoses. A high incidence of generalized xerosis and pruritus was seen in both males and females. Among noninfective dermatoses, 10.1% had eczema, 6.2% acne, 5% melasma, 4.1% palmoplantar keratoderma, 3.2% neurotic excoriations, 3.2% dermatitis artifacta, 2.7% trichotillomania, 2.1% miliaria, and 1.4% had ichthyosis.Conclusion A high incidence of fungal infections mainly tinea versicolor and onychomycosis was seen in the patients with primary psychiatric conditions.References
Millard LG, Millard J. Psychocutaneous Disorders. In: ChampioRH, Burton JL, Ebling FJ, editors. Rook’s Textbook of Dermatology, 8th Edn. Oxford: Wiley- Blackwell; 2010. p. 64.1-64.55.
Gupta MA, Gupta AK. Psychodermatology: an update. J Am Acad Dermatol. 1996;34:1030-46.
Medansky RS, Handler RM. Dermatopsychosomatics: classification, physiology, and therapeutic approaches. J Am Acad Dermatol. 1981;5:125-36.
Kidd CB, Meenan JC. Dermatological survey of long stay mental patients. Br J Dermatol. 1961;73:129-33.
Sneddon J, Sneddon I. Acne excoriée; a protective device. Clin Exp Dermatol. 1983;8:65-8.
Koo JM, Smith LL. Psychologic aspects of acne. Pediatr Dermatol. 1991;8:185-9.
Lyell A. Delusion of parasitosis. Semin Dermatol. 1983;2:189-95.
Hay CG. Dysmorphophobia. Br J Psychiatry. 1970;116:399-406.
Kuruvila M, Gahalaut P, Zacharia A. A study of skin disorders in patients with primary psychiatric conditions. Indian J Dermatol Venereol Leprol. 2004;70:292-5.
Fabisch W. Psychiatric aspects of dermatitis artefacta. Br J Dermatol. 1980;102:29-34.
Graber J, Arndt WB. Trichotillomania. Compr Psychiatry. 1993;34:340-6.
Christenson GA, Mackenzie TB, Mitchell JE. Characteristics of 60 adult chronic hair pullers. Am J Psychiatry. 1991;148:365-70.