Building a Psychodermatology Clinic

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There is a need for a holistic view when treating dermatological patients. Dermatologists believe that psychiatric disorders are substantially less frequent than they actually are in many skin conditions. In many skin conditions the frequency of psychiatric disorders are underestimated by dermatologists. Diagnosing psychodermatological disorders, particularly depression, could in some cases, be lifesaving. In at least university teaching hospitals, psychodermatology clinics should function on a regular basis. The most natural location of such a clinic is within an ordinary dermatology clinic containing an interdisciplinary team of a dermatologist, psychiatrist, psychologist, social worker and experienced nurse. Instruments used include somatic examination, laboratory tests, and radiology facilities such as magnetic resonance, and neurophysiological examination. Treatment is composed of skin handling, emolliants, hydrocolloid dressings, ultraviolet light therapy, cognitive behavioural therapy, and/or pharmacotherapy using antidepressants or antipsycotics. These psychodermatological clinics, depending on refunding, may not be lucrative from the refunding perspective but they offer integrative patient care and may limit number of hospital admissions and improve the quality of life of these patients, this being the ultimate purpose.