$Unique_ID{BRK00370} $Pretitle{} $Title{Can Rash be Caused by Mental State?} $Subject{rash dermatitis depression Mental Emotional psychological dermatological situations rashes factitial stress stresses intense itch pruritus psychosomatic skin disease excoriation crust tranquilizer bland cream} $Volume{E-20} $Log{} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Can Rash be Caused by Mental State? ------------------------------------------------------------------------------ QUESTION: I recently visited my mother, who is suffering a depression since my father died two months ago. I found her arms covered with crusty sores, and she complained of fierce itching. My aunt says the rash is coming from her mental state. Can that be true? ------------------------------------------------------------------------------ ANSWER: Your aunt is on the right track, although it isn't a simple cause and effect situation. As with all dermatological situations, it is difficult to make a diagnosis without seeing the rash, but if they seemed to be in straight lines on the outside or back of the arms, they would conform to a description of a factitial dermatitis, or one that is produced by the patient herself, usually unintentional. And that can be the case in certain conditions where the stress of a recent loss can be the underlying cause for the beginning of an intense itch or pruritus. This type of psychosomatic skin disease requires an alert clinician to find the elements of the problem in a careful, complete, case history when the characteristics of the rash provide the first clue. The "rash" is really an excoriation or a hollowed out area caused by scratching, rubbing or picking. As part of the healing process, a crust is formed to protect the underlying tissue, but frequently that too is picked away. Your mother needs the reassurance of her physician that all will be well, and perhaps a tranquilizer and a bland cream to place on her sores. All will be well, but it make take up to 6 months to achieve. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.