New Proposed Classification for Psychodermatosis Based on the Complex Interaction Between the Brain and Skin

The literature describes several dermatological conditions that are not caused by external agents but result from the complex interaction between the brain and the skin. This interaction gives rise to a variety of dermatological lesions, which can be broadly classified into two major categories: psychogenic dermatoses and psychosomatic dermatoses. In this article, we present three cases of Psychodermatosis to illustrate a proposed detailed classification based on the underlying mechanisms and clinical manifestations of these conditions. The cases include: (1) crusty, greasy, brownish facial lesions; (2) excoriated lesions with post-inflammatory hypopigmentation, alopecia, and fractured hairs—characteristic of trichotillomania; and (3) lichenified plaques on the dorsum of the feet, leaving hyperpigmented and atrophic hypopigmented scars, typical of factitious dermatitis. We propose a refined dermatological classification of Psychodermatosis, encompassing two primary categories: (1) cutaneous diseases associated with psychiatric disorders and (2) psychiatric conditions linked to specific cutaneous disorders known to be influenced by psychosomatic factors.