Psychosomatic Dermatology

It has long been recognized that psychosomatic factors play a role in dermatologic disease.1The past four decades have seen a marked progress in the understanding of the biologic basis of psychopathology and in the development of pharmacologic treatments for mental disorders. However, at present, psychosomatic dermatology is, at best, on the fringes of mainstream clinical dermatology. Do dermatologists need to familiarize themselves with psychiatric principles along with the principles of general internal medicine? How clinically relevant is the relation between the psyche and the skin? The following perspectives on some interfaces between psychiatry and dermatology may shed light on these questions. PSYCHONEUROIMMUNOLOGIC INTERRELATIONSHIPS There is evidence that central nervous system (CNS) processes modulate immune function and that the immune system in turn provides feedback to the brain.2-5Some of the many findings2-5that support the preceding statement include the following: hypothalamic lesions affect immune function; the