壓力引致(皮膚)細胞發炎

 http://www.psychiatrictimes.com/display/article/10168/2003159?_EXT_4_comsort=of

牛皮癬

CASE VIGNETTE

A 52-year-old man with psoriasis that had been well controlled with topical and oral medications was recently laid off from his job. His financial difficulties and resultant stress started affecting his marriage; this made him irritable, angry, and frustrated and left him feeling stressed.

His psoriasis flared up significantly, and medications were no longer effective. He became too embarrassed to shake hands with people or to go out in public. His wife refused to have any physical contact with him and eventually filed for divorce.

The patient was seen by several dermatologists and went through several medication trials. Eventually, he was referred to a tertiary care hospital and was admitted on an inpatient dermatology unit. A psychodermatology consultation was requested, and the temporal relationship with his current stressful situation was established. The patient was discharged on a weekly regimen that focused on supportive therapy and cognitive-behavioral therapy (CBT). After 6 weeks, his psoriatic lesions started to heal. He continued his dermatological treatment.

濕疹

CASE VIGNETTE

A 10-year-old boy with a history of atopic eczema, mostly on extensor surfaces of upper and lower extremities, and with generalized dry skin had been doing well; his skin lesions had been well controlled with medications. His mother’s sudden death in a car accident adversely affected his functioning: his grades declined, he lost his appetite, and he began to have trouble falling asleep. His eczema flared up, and his whole body was covered with oozing and itchy lesions. Medications that had controlled the lesions were no longer effective.

He had low self-esteem and felt embarrassed in social situations. Consequently, he confined himself to his home and refused to go to school. He also started cutting his wrists and voiced thoughts of self-harm. He was referred by his treating dermatologist to a psychodermatologist, who established the relationship between his psychosocial stress and the current exacerbation of lesions.

Supportive psychotherapy that focused on grief and CBT used to address his cognitive distortions proved helpful. His lesions started healing in about 3 weeks.

 

Psychodermatology: When the Mind and Skin Interact

By Mohammad Jafferany, MD | 08 December 2011

http://www.psychiatrictimes.com/display/article/10168/2003159?pageNumber=2