Psychoneurotisch bedingte Krankheitszustände der Haut

  • Constantin E. Orfanos
  • Claus Garbe

Zusammenfassung

Krankheiten der Haut haben ihrer Natur und Lokalisation nach häufig psychische Auswirkungen, zumal der Kranke in der Lage ist, seine Krankheit nicht nur durch die damit verbundene Beschwerdesymptomatik zu fühlen, sondern auch die Krankheit selbst zu sehen. Die Hautkrankheit beeinträchtigt die Kommunikation mit seiner Umwelt oder stellt sogar Barrieren auf. Schon dadurch können psychosomatische bzw. psychoneurotische Störungen, nicht zuletzt bei entsprechender Labilität des Krankheitsträgers, bei vielen Krankheiten der Haut entstehen. Auch die Chronizität mancher Hautkrankheiten trägt entscheidend dazu bei. Der Therapeut muß in jedem Einzelfall auch die psychosozialen Aspekte des Hautleidens und ihre Auswirkungen bei seiner Therapieplanung berücksichtigen. Eine auf die psychische Einstellung des Kranken adaptierte Therapie wird eher zum Erfolg führen.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Alexander CR (1991) Fluoxetine treatment of trichotillomania (letter). J Clin Psychiatry 58: 88Google Scholar
  2. Alexander J O’D (1984) Arthropods and human skin. Springer, Berlin Heidelberg New York Tokyo Arzneimittelkommission der Deutschen Ärzteschaft (1990) Juckreiz nach Infusion mit Hydroxyäthylstärke ( HES ). Dtsch Ärztebl 30: 2326Google Scholar
  3. Beard AW, Jopling WH, Reilly TM (1978) Successful treatment with pimazide of delusional parasitosis. Br J Dermatol 98:457–459PubMedGoogle Scholar
  4. Bishop ER Jr (1983) Monosymptomatic hypochondriacal syndromes in dermatology. J Am Acad Dermatol 9: 152–158PubMedCrossRefGoogle Scholar
  5. Blume U, Zouboulis CC, Bratzke B et al. (1993) Painful bruising syndrome: a psychogenic dermatosis. Eur J Dermatol 3: 364–366Google Scholar
  6. Bond WS (1989) Delusions of parasitosis: a case report and management guidelines. Ann Pharmacother 23: 304–306Google Scholar
  7. Choubrac P, Cornu P et al. (1974) Purpura douloureux ecchymotique. Syndrome de Gardner et Diamond. Ann Med Interne (Paris) 125: 323–332Google Scholar
  8. Conolly FH, Gipson M (1978) Dysmorphophobia, a long term study. Br J Psychiatry 132: 568–570CrossRefGoogle Scholar
  9. Cotteril JA (1981) Dermatologie non-disease: A corn-mon and potentially fatal disturbance of cutaneous body image. Br J Dermatol 104: 611–619CrossRefGoogle Scholar
  10. Damiani JT, Flowers FP, Pierce DK (1990) Pimozide in delusions of parasitosis. J Am Acad Dermatol 22: 312–313PubMedCrossRefGoogle Scholar
  11. Dech B, Budow L (1991) The use of fluoxetine in an adolescent with Prader-Willi syndrome. J Am Acad Child Adolesc Psychiatry 30: 298–302PubMedCrossRefGoogle Scholar
  12. Denman ST (1986) A review of pruritus. J Am Acad Dermatol 14: 375–392PubMedCrossRefGoogle Scholar
  13. Driscoll MS, Rothe MJ, Grant-Kels JM et al. (1993) Delusional parasitosis: A dermatologic, psychiatric, and pharmacologic approach. J Am Acad Dermatol 29: 1023–1033PubMedCrossRefGoogle Scholar
  14. Dupont C, de Maubeuge J, Kotlar Wet al. (1984) Oxatomide in the treatment of pruritus senilis. A double-blind placebo-controlled trial. Dermatologica 169: 348–353PubMedCrossRefGoogle Scholar
  15. Elpern DJ (1988) Cocaine abuse and delusions of parasitosis. Cutis 42: 273–274PubMedGoogle Scholar
  16. Fabisch W (1980) Psychiatric aspects of dermatitis artefacta. Br J Dermatol 102: 29–34PubMedCrossRefGoogle Scholar
  17. Fjellner B, Hägermark O (1979) Pruritus in polycythaemia vera: Treatment with aspirin and possibility of platelet involvement. Acta Derm Venereol 59: 505–512PubMedGoogle Scholar
  18. Frankel EB (1983) Treatment of delusions of parasitosis. J Am Acad Dermatol 9: 772–773PubMedCrossRefGoogle Scholar
  19. Frithz A (1979) Delusions of infestation: Treatment by depot injections of neuroleptics. Clin Exp Dermatol 4: 485–488PubMedCrossRefGoogle Scholar
  20. Gardner FH, Diamond LF (1955) Autoerythrocyte sensitization. A form of purpura producing painful bruising following autosensitization to red blood cells in certain women. Blood 10: 675–690PubMedGoogle Scholar
  21. George SM, Brewerton DT, Cochrane G (1990) Trichotillomania (nair pulling). N Engl J Med 322: 470–471CrossRefGoogle Scholar
  22. Gould WM, Gragg TM (1976) Delusions of parasitosis. A approach to the problem. Arch Dermatol 112: 1745–1748PubMedCrossRefGoogle Scholar
  23. Greenberg HR et al. (1965) Trichotillomania. Arch Gen Psychiatry 12: 482–486PubMedCrossRefGoogle Scholar
  24. Gupta MA et al. (1986) Psychotropic drugs in dermatology. J Am Acad Dermatol 14: 633–645PubMedCrossRefGoogle Scholar
  25. Gupta MA, Gupta AK, Haberman AF (1987) The self-inflicted dermatoses: a critical review. Gen Hosp Psychiatry 9: 45–52PubMedCrossRefGoogle Scholar
  26. Hamann K, Avnstorp C (1982) Delusions of investation treated by pimozide. A double blind crossover clinical study. Acta Derm Venerol 62: 55–58PubMedGoogle Scholar
  27. Hay GG (1970) Dysmorphobia. Br J Psychiatry 116: 399–406PubMedCrossRefGoogle Scholar
  28. Hermann J, Gall H (1990) Diagnose and Therapie des persistierenden Pruritus nach Infusion mit Hydroxyäthylstärke ( HAS ). Akt Dermatol 16: 166–167Google Scholar
  29. Hersle K, Mobacken H (1969) Autoerythrocyte sensitization syndrome (painful bruising syndrome). Br J Dermatol 81: 574–587PubMedCrossRefGoogle Scholar
  30. Holmes VF (1989) Treatment of monosymptomatic hypochondriacal psychosis with pimozide in an AIDS patient. Am J Psychiatry 146: 554–555PubMedGoogle Scholar
  31. Hüneke P, Bosse K (1985) Dysmorphophobie als casus pro diagnosi. Z Hautkr 60: 1986–1990Google Scholar
  32. Jacobi E (1929) Psychogene Spontanblutung der Haut. Arch Psychiatry Nervenkr 88: 631–645CrossRefGoogle Scholar
  33. Koblenzer CS (1983) Psychosomatic concepts in dermatology: A dermatologist psychoanalyst’s viewpoint. Arch Dermatol 119: 501–512PubMedCrossRefGoogle Scholar
  34. Koblenzer CS (1985) The dysmorphic syndrome. Arch Dermatol 121: 780–784PubMedCrossRefGoogle Scholar
  35. Knowlws S, Shear NH (1989) Antihistamines. Clin Dermatol 7: 48–59CrossRefGoogle Scholar
  36. Krishnan RR, Davidson J, Miller R (1984) MAO inhibitor therapy in trichotillomania accociated with depression: Case report. J Clin Psychiatry 45: 267–168PubMedGoogle Scholar
  37. Krishnan KR, Davidson JR, Guajardo C (1985) Tricho- tillomania — a review. Compr Psychiatry 26: 123–128PubMedCrossRefGoogle Scholar
  38. Laihinen A (1991) Assessment of psychiatric and psychosocial factors disposing to chronic outcome of dermatoses. Acta Dermatol Venereol 156: 46–48Google Scholar
  39. Leibsohn E (1992) Treatment of notalgia paresthetica with capsaicin. Cutis 49: 335–336PubMedGoogle Scholar
  40. Leutner A, Warmke S, Genzel I et al. (1990) Persistierender Pruritus nach Hydroxyäthylstärke-Infusion? Z Hautkr 66: 214–221Google Scholar
  41. Liebowitz MR, Nuetzel EJ, Bowser AE, Klein DF (1978) Phenelzine and delusions of parasitosis: A case report. Am J Psychiatry 135: 1565–1566PubMedGoogle Scholar
  42. Lindskov R, Baadsgaard O (1985) Delusions of infestation treated with pimozide: a follow-up study. Acta Derm Venereol 65: 267–270PubMedGoogle Scholar
  43. Lyell A (1983) Delusions of parasitosis. Br J Dermatol 108: 485–499PubMedCrossRefGoogle Scholar
  44. Marschall MA, Dolezal RF Gohen M et al. (1991) Chronic wounds and delusions of parasitosis in the drug abuser. Plast Reconstr Surg 88: 328–330PubMedCrossRefGoogle Scholar
  45. Massey EW, Pleet AB (1979) Localized pruritus-notalgia paresthetica. Arch Dermatol 115: 982–983PubMedCrossRefGoogle Scholar
  46. McGehee FT Jr, Buchanan GR (1980) Trichophagia and trichobezoar: etiologic role of iron deficiency. J Pediatr 97: 946–948PubMedCrossRefGoogle Scholar
  47. Mishler J (1982) Pruritus after administration of hetastarch. Br Med J 284: 1405–1406Google Scholar
  48. Mitchell C (1989) Successful treatment of chronic delusional parasitosis. Br J Psychiatry 155: 556–557PubMedCrossRefGoogle Scholar
  49. Mitchell J, Vierkant AD (1991) Delusions and hallucinations of cocaine abusers and paranoid schizophrenics: a comparative study. J Psychol 125: 301–310PubMedGoogle Scholar
  50. Moffaert M van (1991) Localization of self-inflicted dermatological lesions: What do they tell the dermatologist? Acta Dermatol Venereol 156: 23–27Google Scholar
  51. Muller SA (1990) Trichotillomania and related disorders. In: Orfanos CE, Happle R (eds) Hair and hair diseases. Springer, Berlin Heidelberg Ney York Tokyo, pp 753–762CrossRefGoogle Scholar
  52. Muller SA (1990) Trichotillomania: A histopathologic study in sixty-six patients. J Am Acad Dermatol 23: 56–62PubMedCrossRefGoogle Scholar
  53. Munro A (1978) Monosymptomatic hypochondriacal psychosis manifesting as delusion of parasitosis. A description of four cases successfully treated with pimozide. Arch Dermatol 114: 940–943PubMedCrossRefGoogle Scholar
  54. Naylor WM, Grossman M (1991) Trichotillomania and depression (letter). J Am Acad Child Adolesc Psychiatry 30: 155–156PubMedCrossRefGoogle Scholar
  55. Oranje AP, Peerboom-Wynia ID, De Raeymaecker DM (1986) Trichotillomania in childhood. J Am Acad Derm 16: 614–619CrossRefGoogle Scholar
  56. Ratnoff OD, (1980) The psychogenic purpuras: a review of autoerythrocyte sensitization, autosensitiazion to DNA, „hysterical“ and factitial bleeding and the religious stigmata. Sem Hematol 17: 192–213Google Scholar
  57. Reilly TM, Jopling WH, Beard AW (1978) Successful treatment with pimozide of delusional parasitosis. Br J Dermatol 98: 457–459PubMedCrossRefGoogle Scholar
  58. Sachadeva JS, Siduh BS (1987) Trichotillomania with depression. J Indian Med Assoc 85: 151–152Google Scholar
  59. Schnurr RG, Davidson S (1989) Trichotillomania in a ten year old boy: gender identity issue formulated terms of individual and family factors. Can J Psychiatry 34: 721–724PubMedGoogle Scholar
  60. Settle EC (1983) Autoerythrocyte sensitization successfully treated with antidepressants. JAMA 250: 1748–1749CrossRefGoogle Scholar
  61. Sheikha SH, Wagner KD, Wagner RF (1993) Fluoxetine treatment of trichotillomania and depression in a prepubertal child. Cutis 51: 50–52PubMedGoogle Scholar
  62. Shustik C (1977) Gardner-Diamond’s syndrome in a man. Arch Intern Med 137: 1621–1622PubMedCrossRefGoogle Scholar
  63. Sneddon IB (1979) The presentation of psychiatric illness to the dermatologist. Acta Derm Venerol 59: 177–179Google Scholar
  64. Stocker WW, McIntyre OR, Clendenning WE (1977) Psychogenic purpura. Arch Dermatol 113: 606–609PubMedCrossRefGoogle Scholar
  65. Swedo SE, Leonhard HL, Rapoport JL et al. (1989) A double blind comparison of clomipramine and desipramine in the treatment of trichotillomania. N Engl J Med 321: 497–501PubMedCrossRefGoogle Scholar
  66. Trapert W (1991) Zur Epidemiologie des Dermatozoenwahns. Nervenarzt 62: 165–169Google Scholar
  67. Vakilzadeh F, Bröcker EB (1981) Syndrom der Blauen Flecken. Hautarzt 32: 309–312PubMedGoogle Scholar
  68. Wahlgren CF, Hagermark O, Bergström R, Hedin B (1988) Evaluation of a new method of assessing pruritus and antipruritic drugs. Skin Pharmacol 1: 3–13PubMedCrossRefGoogle Scholar
  69. Weber PJ, Poulos EG (1988) Notalgia paresthetica. J Am Acad Dermatol 18: 25–30PubMedCrossRefGoogle Scholar
  70. Weller EB, Weller RA, Carr S (1989) Imipramine treatment of trichotillomania and coexisting depression in a seven year old. J Am Acad Child Adolesc Psychiatry 28: 952–953PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • Constantin E. Orfanos
    • 1
  • Claus Garbe
    • 1
  1. 1.Universitäts-Hautklinik und PoliklinikKlinikum Benjamin Franklin der Freien Universität BerlinBerlinDeutschland

Personalised recommendations