| Title | : | Pathomimesis: psychiatric and medico-legal interference in dermatology |
| Authors | : | Mihaela Anca Popescu, Dumitru-Justin Diaconu, Roxana Vicu, Silvia Vasile, Mădălina Geantă, Maria Magdalena Mîinea |
| : | Rom J Leg Med [19] 277-282 [2011] |
Abstract:
Psychodermatology deals with the psychological causes of cutaneous disorders and the patient’s psychological predisposition to suffer from skin diseases. Dermatologic disorders can be purely somatic or somatic diseases with a noticeable effect on the psyche, somatic disorders with emotional trigger factors, as well as exclusively psychological illnesses. The skin is considered a “mirror of the soul” and the connection between the skin and the nervous system has been demonstrated. Between 20-40% of the patients in the dermatology wards have some type of psychiatric problem, therefore physicians must be familiar with these disorders and with the proper ways to approach the patient, in order to establish an accurate diagnosis and treatment method.
The present paper describes the most commonly encountered psychodermatological disorders, both in terms of symptoms and clinical signs, and of the psychiatric and forensic ramifications. Further progress has been made in understanding and treating these diseases situated at the interface of dermatology and psychiatry.
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Deep vein thrombosis is a common disease entity to which attention should be paid due to its complication of pulmonary embolism. This disease usually has precipitating factors such as obesity, varicose veins or nonambulation. Congenital coagulation defects should be suspected if patient has recurrent deep vein thrombosis without identifiable precipitating factors. We report a case of 44-year-old Japanese male, who had three events of deep vein thrombosis within four years. Doppler ultrasound study at the time of the first event showed extensive thrombosis of femoral veins. Coagulation factors study revealed that patient had antithrombin III deficiency. This patient’s sister in Japan also had this defect. This patient is using warfarin 5 mg daily and has been followed up uneventfully. In patients with recurrent deep vein thrombosis, hereditary coagulation defect should be suspected and warfarin should be used indefinitely.
