Article

Evaluation and treatment of 'psychogenic' pruritus and self-excoriation

SUNY Health Science Center, Brooklyn 11203.
Journal of the American Academy of Dermatology (Impact Factor: 5). 07/1994; 30(6):993-9. DOI: 10.1016/S0190-9622(94)70125-3
Source: PubMed

ABSTRACT Psychogenic pruritus and self-excoriation are diagnoses of exclusion. Elimination of traditional organic causes often leads the clinician to label a symptom as psychogenic in origin and limits treatment options. This article examines the organic and psychologic causes and concomitants of dermatologic conditions associated with pruritus and self-excoriation. An organized cognitive framework is presented to guide the clinician in the evaluation and treatment of these patients. Specific treatment options are offered and relevant psychopharmacologic agents are reviewed.

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    • "Although this is by no means an exhaustive review of medication side effects, it does show that symptoms experienced by delusory parasitosis sufferers may have valid physiological causes, either in medical conditions or in the drugs prescribed for their treatment. Psychologists and dermatologists have noted that organic causes must be excluded before a diagnosis of psychogenic pruritus can be made (Freyne and Wrigley 1994, Gupta 1995). Because of the numerous potential physiological causes of pruritus, urticaria, and paresthesia, it is understandable that physicians often do not attempt to treat underlying causes but, instead, prescribe palliatives or advise the patient to pursue entomological possibilities (which fits with the patient's inclinations, anyway). "
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