Psychocutaneous Medicine: Present Status and Trends of Inquiry

Abstract

ANT investigator in a narrow field should, every few years-^half a decade seems a suitable interval-pause, sit back, and try to assess objectively the status of his chosen specialty.In 1955, I was invited by the editors of " Excerpta Medica " to contribute to its Milestones in Dermatology on the subject of psycho cutaneous medicine. I said then, " The influence of psychic and emotional factors on certain inflammatory dermatoses is acknowledged by most investigators. Considerable divergence of opinion exists, however, as to the range of that influence and as to the mechanism by which an emotional impulse gives rise to a cutaneous symptom." That divergence still exists.Moreover, we must admit that the ultimate goal of our labour, the closure of the gap between mind and body by demonstrating the exact mechanism by which our emotional stimulus turns into a somatic symptom has so far eluded us. The old controversy, however, whether mind or body plays the crucial role, no longer goes on. It is now a question of the best explanation of the interrelationship.Considerable progress has been made by the various methods of approach used in the study of psychocutaneous medicine, namely : psychologic, neurophysiologic and biochemical research, studies in allergy, genetics and the application of social psychiatry. We shall see that research in aU of these fields converges on one central theme: no single branch of science can find the whole answer independently of the others. PSYCHOLOGIC EESEARCH.Psychologic research, undertaken on both conscious (superflcial) and unconscious (deep) levels has continued to reveal data of importance.My^ co-workers and I (1957) have continued our research on patients with disseminated neurodermatitis. But instead of following the well-trodden path of general psychologic study, we have endeavoured to define minutely the specific emotional attitudes which are signiflcantly related to exacerbations of the dermatosis. We believe that our method has succeeded in elucidating the type of emotional illness these patients have.It is a psychosis sine psychosi or, in other words, a highly specialized reaction resembling psychosis, crises acted out in the skin without otherwise losing contact with reality. By this we do not mean that the patient is deranged. We mean that he responds to the world with inappropriate patterns of reaction, physiologic and psychologic, incorporated during the infant developmental period of life, which interfere with normal reactions. We are not alone in the demonstration of a mechanism in psychocutaneous reactions which is closer to psychosis rather

Cold urticaria and your risk of anaphylaxis

“…The effects of treatment with antibiotics 11 , such as doxycycline 29 , can be beneficial for patients with CU even with complete remission of symptoms, as shown by several case reports [30][31][32][33][34] . A retrospective analysis using 200 mg/day of doxycycline for 7 to 28 days showed complete remission in 19% of patients and partial remission in 15% after treatment.Response assessment before and after antibiotic therapy was conducted after the discontinuation of antihistamines for at least 48 h. This response was not associated with disease duration or severity, patient age, or treatment period 29 .…”

Patients with chronic cold urticaria may benefit from doxycycline therapy

“…Successful treatment of ColdU with antibiotics has been reported earlier in case reports and small case series . Möller et al ., in 1996, described remission of ColdU in five of 10 patients after treatment with tetracycline .…”

“…Successful treatment of ColdU with antibiotics has been reported earlier in case reports and small case series. [10][11][12] M€ oller et al, in 1996, described remission of ColdU in five of 10 patients after treatment with tetracycline. 8 In our study, 34% of patients with ColdU benefited from the treatment with doxycycline, with half of them showing full remission.…”