THE PSYCHOSOCIAL IMPACT OF SKIN-DISEASE - AN OVERVIEW

When the skin is disfigured by disease, it has an impact on the afflic ted person. The intensity of the effect depends on many variables incl uding the natural history of the disease, the characteristics of the i ndividual patients and their life situation, as well as the attitudes and assumptions of the culture at large about the meaning of skin dise ase. Fantasies about skin disease, shared by patients and onlookers al ike, relate to guilt, control of bodily boundaries, and perfectionist yearnings. Some issues involved in these fantasies include distortions about contagion, dirt, and sexuality. Ways of helping patients to man age the impact of their skin disease include an empathic doctor-patien t alliance, education of patients and the community, and if indicated, referral for psychiatric consultation.