Psychodermatological disorders as an interdisciplinary problem: diagnostic features based on the example of our own clinical observations

At the present stage, there is an increase in the prevalence of psychodermatological disorders, while this pathology has a pronounced negative impact on the quality of life of patients. The observed bidirectional relationship between psychological well-being and skin health is being actively studied. Skin lesions can be caused by primary psychiatric diseases or provoke their appearance. The clinical symptoms of autodestructive dermatoses can imitate parasitic infections and pyoderma, skin tuberculosis, granulomatous and allergic diseases, vasculitis, and lymphomas. In this regard, patients initially seek medical help from doctors of various profiles, which, in the absence of proper awareness of specialists, often lengthens the diagnostic search, leads to progression of the disease and a deterioration in the quality of life of patients. Increasing awareness of psychodermatological comorbidity among primary care physicians is important to reduce the time required to make a correct diagnosis and timely referral of patients to a psychiatrist. The article provides an analysis of our own clinical observations of patients with psychodermatological pathology, for whom more than a year passed from the initial visit to the doctor to verification of the diagnosis. Late diagnosis was accompanied by an increase in symptoms with the formation of pronounced destructive skin lesions. The diagnostic search was also hampered by the significant similarity of the clinical picture with other diseases that have skin symptoms. When analyzing the presented clinical cases, attention is focused on the need for a thorough differential diagnostic search, an analysis of the characteristics of the anamnesis and characteristic symptoms of the skin process in psychodermatological pathology is provided. The importance of an integrated approach to patient management with the participation of specialists from both psychiatric and dermatological profiles was noted.