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Psychosomatic factors in dermatology (Psychodermatology)

6 June 2012, by CONSOLI S.G.


In dermatology like in general medicine, the term “psychosomatic” generally refers to any somatic disorder with objectively observable anatomoclinical or biological changes triggered essentially by psychological factors (events experienced, stress, personality traits or social environment of the subject). However, in various works carried out in this field of dermatology, the concept of “psychodermatology”, which was invented by the Anglo-Saxons, is gradually replacing the term “psychosomatic”. The term “psychodermatology” not only takes into account skin diseases considered as “psychosomatic”, but also:

— psychiatric symptoms of certain organic disorders (e.g. acute cutaneous lupus erythematosus);

— purely functional somatic symptoms (such as psychogenic pruritus);

— the somatic consequences of instinctual behaviour disorders or of behaviour disorders (such as factitious disorders);

— thought or identity disorder symptoms that are expressed somatically (such as delusional parasitosis or body dysmorphic disorder);

— somatic symptoms of depression or anxiety;

— the social and psycho-affective impact of somatic disorders (i.e. psoriasis orprogressive systemic sclerosis);

— careful consideration of the patient-physician relationship (particularly as regards compliance).

In any event, taking into account the psychological aspect of skin diseases, whether referred to as a psychosomatic or psychodermatology approach, involves considering a person with a unique history, an ill patient viewed in his/her emotional and social context, and the approach is not only reserved for certain patients or diseases. The approach can be used for any somatic disorder (in dermatology for example, for psoriasis, pemphigus, acne or melanoma), but it requires the consideration of various theoretical backgrounds and a fundamental respect of biological facts.

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