Handbook of Psychodermatology Abdul Latheef EN
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1Handbook of PSYCHODERMATOLOGY2
3Handbook of PSYCHODERMATOLOGY
Editor-in-Chief Abdul Latheef EN MD DVD FIMSA MSc Psychology Associate Professor Department of Dermatology and Venereology Medical College Kozhikode, Kerala, India Formerly, National Coordinator, Psychodermatology SIG Assistant Editor Smitha Prabhu S MD DVD Associate Professor Department of Dermatology Kasturba Medical College and Hospital Manipal, Karnataka, India Chief Advisor Shrutakirthi D Shenoi MD Professor Department of Dermatology Kasturba Medical College and Hospital Manipal, Karnataka, India Forewords Venkataram Mysore John Koo Tina Bhutani
4
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Handbook of Psychodermatology
First Edition: 2016
9789386056887
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5Contributors 6Foreword
Skin is the mirror of mind and body. Skin reflects mind and mind impacts skin. There is a close synergy of beauty, skin and mind. There are several skin diseases which affect the mind and there are several psychological issues leading to profound skin diseases. Several diseases like vitiligo, psoriasis, eczema all affect the psyche. And in these modern times of increasing stressful life, stress is playing an increasing part in manifestations and management of skin diseases. Psychological counseling and management is, therefore, vital. In addition to these, the concept of beauty is emotional and each person perceives beauty in his own way. The recent fascination for beauty and awareness of esthetic procedures has meant that this aspect of psychodermatology has become increasingly important. Assessment of psychological status of patients, judging their expectations, and determining their suitability for esthetic procedures have all become important to ensure a successful and satisfactory patient-doctor relationship.
There is a greater need for dermatologists to understand the psyche, in addition to understanding the skin. However, the subject of psycho-dermatology has received little focused concerted attention and there are only a few experts in India who specialize in this subspecialty. It is not included in the postgraduate teaching curriculum and only recently has it found a place in conference scientific programs. There has been no textbook nor has there been any course on the subject.
It is, therefore, refreshing to see Dr Abdul Latheef EN, Shrutakirthi D Shenoy and Smitha Prabhu venturing to edit a book on this subject. I was delighted to know of their project and more than happy to contribute two chapters on the psychological aspects of esthetic treatments. The book deals extensively on diagnostic and therapeutic aspects of the subject. The book is comprehensive and includes chapters on meditation, psychopharmacology and the liaison clinic for psychodermatology. The book, therefore, fills a void, a niche that has been waiting to be satisfied.
I compliment the authors and thank them for making me a part of it. The book, I am sure, will be welcomed by dermatologists all over India and abroad. More importantly, I hope the effort will stimulate dermatologists to learn and practice this subspecialty. I am sure the authors will feel rewarded if this book creates an impetus for further awareness and research on this very important subject.
Venkataram Mysore
MD DNB DipRCPath (Lond) FRCP (GLASGOW) FISHRS
Dermatologist, Dermatopathologist and Hair Transplant Surgeon
Director
Venkat Charmalaya – Centre for Advanced Dermatology and Postgraduate
Training Centre
Bengaluru, Karnataka, India
President
Indian Association of Dermatologists, Venereologists
and Leprologists, 2015
mnvenkataram@gmail.com
7Foreword
This book on the topic of pscyhodermatology organized by Dr Abdul Latheef EN is a great contribution to the field of dermatology, not only in India, but worldwide. It is well known that a large proportion of patients seen by dermatologists in practice have significant psychological issues. These issues range from common skin disorders, such as psoriasis and eczema, flaring with stress to patients with extensive self-induced skin injuries and even to patients who are delusional, such as cases of delusions of parasitosis or other forms of delusional ideations. Most importantly, most dermatologists worldwide do not feel adequately prepared to deal with these pscyhodermatology cases. This is not at all surprising in view of the fact that systematic teaching regarding different categories of psychodermatological disorders, the use of psychopharmacologic agents and nonpharmacological therapeutic options such as psychotherapy, hypnotherapy, meditation, etc. are virtually absent in dermatology residency training programs worldwide. Moreover, whether looking at dermatology meetings in any particular country or even the World Congress of Dermatology, there are a few sessions devoted to this extremely important topic. In fact, the very first and only international pscyhodermatology meeting that was ever organized in Asia took place in Manipal, Karnataka, India, and Dr John Koo and I were fortunate enough to be invited to this seminal event.
In view of this grossly inadequate training in psychodermatology for our specialty worldwide, a book like this one that covers comprehensively the “A to Z” of psychodermatology is precious indeed. This book not only explains in detail the common psychodermatological disorders encountered in day-to-day practice, but also shows how they can be categorized in a clinically relevant way such as the distinction between “primary psychiatric disorders” vs “secondary psychiatric disorders” vs “psychophysiological disorders”. Moreover, this gives an overview as well as critical details, on both pharmacological as well as nonpharmacological therapeutic options including meditation. In addition, there are chapters devoted to special subcategories of dermatological practice such as esthetic dermatology and dermatological surgery. Lastly, this book expands on methods to setup a psychodermatology liaison clinic so that these patients can be treated without them feeling stigmatized in the usual dermatological setting where these patients are often not taken seriously or immediately referred to a mental health professional.
In summary, a book like this is a welcome addition to the skillset and knowledge base of our specialty. In view of the fact that psychodermatology has always been so relevant to our practice and yet very much neglected throughout the history of our specialty, we believe that it is not an understatement to say that this book can help dermatologists greatly in any corner of the world.
John Koo MD
Professor and Vice-Chairman
Department of Dermatology
University of California, San Francisco
Tina Bhutani MD
Assistant Professor
Department of Dermatology
University of California, San Francisco
8Preface
Psychodermatology is getting increasing attention in recent years. Emotional or sociocultural factors of influence have dramatically changed the morbidity, pathogenic understanding of causality and therapy concepts in dermatology over the past decades. Since both skin and brain originate from the same ectoderm, skin diseases can affect the mind and vice versa. Psychodermatology covers all aspects of mind-body interactions in relation to the onset and progression of various skin disorders. This is the first book from India and probably from South Asia on this subject written by a multidisciplinary team of psychiatrists, psychologists and dermatologists for all the health professionals who treat patients with skin problems. The concept of liaison clinic is popular in Europe, America and countries like Israel and Singapore. There are reports of some isolated clinics in India.
The present book offers a summarizing overview of clinical patterns in psychodermatology, psychoneuroimmunology, psychological aspect of cosmetic dermatology and sexually transmitted diseases, psychological interventions including meditation, psychopharmacology and the need for a psychodermatology liaison clinic. We have tried to keep the book comprehensive yet simple and reader friendly, to include relevant information useful for a beginner and an expert. We hope we have succeeded in achieving this objective.
I am fortunate to get very many experts as authors, and I express my sincere gratitude to all the authors for their contribution. I record with pride and happiness the splendid work done by Dr Smitha Prabhu (Assistant Editor) and Dr Shrutakirthi D Shenoi (Chief Advisor) without the sincere endeavors of whom the book would not have been possible.
I express my special gratitude to our National President, Dr Venkataram Mysore for blessing this venture with help, advice and contribution. Dr John Koo and Tina Bhutani (University of California, San Francisco), the pioneers in this field, deserve special thanks for blessing us with the foreword.
I express my sincere thanks to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director) and Mr Tarun Duneja (Director-Publishing) of M/s Jaypee Brothers Publishers (P) Ltd, New Delhi, India, for their constant support and outstanding work in bringing out the book on time.
I earnestly hope that the book will be appreciated by the readers and it will serve as an instrument in the progress of psychodermatology. I welcome comments and feedback from the readers.
Abdul Latheef EN