psychiatric effects of skin disease

Question 1

what psychological intrvetnison can help with acne related depression

Answer 1

cognitive behavioural therapy; self-help material; group therapy

Question 2

examples of anti-depressants

Answer 2

certoline; citalipram -> SSRIs

Question 3

examples of psychosocial stress in skin disease measures (6)

Answer 3

1. psoriasis disability index
2. dermatitis family impact questionnaire
3. dermatology life quality index
4. acne disability questionnaire
5. general health questionnaire
6. hamilton rating scales for anxiety and depression

Question 4

examples of skin manifestations of psychological illness (9)

Answer 4

1. self harm
2. dermatitis arterfacta (aka Munchhausen syndrome)
3. parasitosis
4. dysmophophobia
5. trichotillomania
6. excessive handwashing, neurotic excoriations
7. signs od alcohol/substance misuse
8. sun sensitivity
9. nicotine stained fingers
   8

Question 5

what is malingering

Answer 5

concious intent to present with a symptoms in order to obtain a prescription only drug (usually to sell on)

Question 6

how can OCD result in skin damage

Answer 6

repetitive nature of certain acts causes skin damage e.g. scratching, hand washing

Question 7

what is dermatitis artefacta

Answer 7

munchausen’s syndrome - causing harm to oneself to satisfy psychological need e.g. unconscious need to be nurtured -> munchausen by proxy also exists

Question 8

clinical findings that suggest dermatitis artefacta (5)

Answer 8

1. dramatic lesions, calm manner
2. lesions not characteristic of known dermatoses
3. lesions in reach of pt’s hands
4. lesions appear fully formed all at same stage of development
5. hollow history - cant elicit evidence of evolutionary changes

Question 9

what is parasitosis

Answer 9

a delusions where pts believe their bodies are infested with some type of organism - associated with matchbox sign

Question 10

what is the matchbox sign

Answer 10

when patients bring in small fibers or items that they believe are worms or parasites coming out of their body and put them in small containers like matchboxes to show during the doctor visit

Question 11

what is dysmorphophobia

Answer 11

aka body dysmorphia - the belief that an aspect of one’s physical appearance is particularly abnormal and noticeable when it is objectively within normal limits

Question 12

what is trichotillomania

Answer 12

when pts pull out their own hair

Question 13

examples of drugs that cause skin conditions

Answer 13

1. lithium
2. anti-convulsants
3. chlorpromazine
4. steroids
5. lamotrigine

Question 14

what is steven-johnson syndrome

Answer 14

rare hypersentivity reaction to triggers such as mild infection or drugs resulting in leading to blistering and peeling of the skin and surfaces of the eyes, mouth and throat

Question 15

what drugs commonly cause erythema multiforme (6)

Answer 15

1. aminopenicillins (such as co-amoxiclav);
2. sulfonamides;
3. carbamazepine;
4. allopurinol;
5. NSAIDs;
6. oral contraceptive pill