Abstract

A COMPLEX INTERPLAY OF VARIOUS PSYCHO-DERMATOLOGICAL MANIFESTATIONS: A CASE REPORT

Author(s): Chinmay A. Deshpande, Sharmishtha S. Deshpande

Objective: This case on psycho cutaneous disorder is not only reported for its rarity, but to describe the frequently seen yet inaccurately diagnosed complex clinical disorder. It was estimated approximately as many as 25-30% of the out-patients attending dermatology clinics suffering from this condition. Patients are often reluctant for referral to the psychiatrist and pose a difficulty for the management for dermatologists. Methods: We report a case of psycho cutaneous disorder, which was referred by dermatologist. She had multiple dermatological and psychiatric morbidities, which were difficult to diagnose and treat, but managed successfully by good liaison and thorough assessment by the treating team. Result: A middle aged, separated lady was referred for psychiatrist’s opinion with complaints of itchy lesions over upper and lower limbs. She was diagnosed to have excoriation and later developed furunculosis. She also simultaneously had tinea corporis with severe xerosis, i.e. fungal infection with dryness of skin. Patient had nursed her uncle who had suffered from psoriasis. She had fears of acquiring the same illness as the illness may be contagious. On the same time, she had plantar psoriasis, which make felt anxious with depressive symptoms and contemplated suicide. The liaison teams successfully treated her medical and psychiatric problems. Conclusion: This case report highlights how concomitant dermatological and psychiatric co-morbidity was successfully managed by liaison team, which consisted of dermatologist and psychiatrist for speedy recovery.