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LICHEN SIMPLEX CHRONICUS AND ITS VARIANTS: A Discussion of Certain Psychodynamic Mechanisms and Clinical and Histopathologic Correlations

LICHEN SIMPLEX CHRONICUS AND ITS VARIANTS: A Discussion of Certain Psychodynamic Mechanisms and... Abstract IN THIS presentation we will attempt to demonstrate from the clinical and histopathologic standpoint an association between a number of eruptions having in common the element of lichenification. This group includes lichen simplex chronicus and its variants, prurigo nodularis, lichenificatio gigantea, and certain phases of the Sulzberger-Garbe syndrome. We intend, furthermore, to point out that these processes are frequently related to some emotional disturbance. In addition, we shall emphasize that the diagnosis of such psychogenically induced dermatoses often can be made by the clinician on the basis of positive dermatologic and histopathologic findings, rather than by resorting to the negative criterion of exclusion. Without going into a detailed psychiatric explanation, we shall elucidate some psychodynamic mechanisms that may give rise to these cutaneous changes. Emotions are part of the basic hereditary equipment for adaptation. They represent the sensory component of visceral responses (mediated by way of the autonomic and endocrine References 1. Brunner, M. J.: Biologic Basis of Psychosomatic Disease of the Skin , Arch. Dermat. & Syph. 57:374 ( (March) ) 1948. 2. Seitz, P. F. D.: An Experimental Approach to Psychocutaneous Problems , J. Invest. Dermat. 13:199 ( (Oct.) ) 1949. 3. Miller, M. L.: Psychodynamic Mechanisms in a Case of Neurodermatitis , Psychosom. Med. 10:309 ( (Nov.) -Dec.) 1948. 4. Stokes, J. H., and Beerman, H.: Psychosomatic Correlations in Allergic Conditions: A Review of Problems and Literature , Psychosom. Med. 2:438 ( (Oct.) ) 1940. 5. Cormia, F. E.: Psychosomatic Factors in Dermatoses , Arch. Dermat. & Syph. 55:601 ( (May) ) 1947. 6. Cannon, W. B.: The Wisdom of the Body , ed. 2, New York, W. W. Norton & Company, Inc., 1939. 7. Selye, H.: Textbook of Endocrinology , Montreal, Acta Endocrinologica, Inc., 1947, p. 837. 8. Klauder, J. V.: Psychogenic Aspects of Skin Diseases , J. Nerv. & Ment. Dis. 84:249 ( (Sept.) ) 1936. 9. Wright, C. S.: Psychosomatic Factors in Dermatology , South M. J. 42:951 ( (Nov.) ) 1949. 10. English, O. S.: Role of Emotion in Disorders of the Skin , Arch. Dermat. & Syph. 60:1063 ( (Dec.) ) 1949. 11. Seitz, P. F. D.: Psychocutaneous Aspects of Persistent Pruritus and Excessive Excoriation , A. M. A. Arch. Dermat. & Syph. , to be published. 12. Michelson, H. E.: Psychosomatic Studies in Dermatology , Arch. Dermat. & Syph. 51:245 ( (April) ) 1945. 13. Seitz, P. F. D.: Psychogenic Conditioning During the First 2 Weeks of Life , Psychosom. Med. 12:187 ( (May) -June) 1950. 14. Rothman, S.: The Role of the Autonomic Nervous System in Cutaneous Disorders , Psychosom. Med. 7:90 ( (March) ) 1945. 15. Lynch, F. W.: Suboccipital Dermatitis , Arch. Dermat. & Syph. 60:307 ( (Sept.) ) 1949. 16. Sachs, W.; Miller, C. S., and Gray, M. B.: Neurodermatitic Reaction , Arch. Dermat. & Syph. 54:397 ( (Oct.) ) 1946. 17. Ormsby, O. S., and Montgomery, H.: Diseases of the Skin , ed. 7, Philadelphia, Lea & Febiger, 1948, p. 360. 18. Laymon, C. W., and Dixon, A. A.: Lesions of the Scalp in Certain Scaly Dermatoses: Histologic Study , Arch. Dermat. & Syph. 62:181 ( (Aug.) ) 1950. 19. Berlin, C.: Lichenificatio Gigantea (Lichénification Géante of Brocq and Pautrier) , Arch. Dermat. & Syph. 39:1012 ( (June) ) 1939. 20. Ronchese, F.: Neurodermatitis with Giant Lichenification , Arch. Dermat. & Syph. 43:920 ( (May) ) 1941. 21. Sulzberger, M. B., and Garbe, W.: Nine Cases of a Distinctive Exudative Discoid and Lichenoid Chronic Dermatosis , Arch. Dermat. & Syph. 36:247 ( (Aug.) ) 1937. 22. Schneider, E., and Kesten, B.: Polymorphic Prurigo: A Psychosomatic Study of 3 Cases , J. Invest. Dermat. 10:205 ( (March) ) 1948. 23. Sachs, W., and Kirsch, N.: Exudative Discoid and Lichenoid Chronic Dermatosis (Sulzberger-Garbe): Histopathologic Study , J. Invest. Dermat. 8:215 ( (April) ) 1947. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Dermatology & Syphilology American Medical Association

LICHEN SIMPLEX CHRONICUS AND ITS VARIANTS: A Discussion of Certain Psychodynamic Mechanisms and Clinical and Histopathologic Correlations

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Publisher
American Medical Association
Copyright
Copyright © 1951 American Medical Association. All Rights Reserved.
ISSN
0096-5979
DOI
10.1001/archderm.1951.01570090087011
Publisher site
See Article on Publisher Site

Abstract

Abstract IN THIS presentation we will attempt to demonstrate from the clinical and histopathologic standpoint an association between a number of eruptions having in common the element of lichenification. This group includes lichen simplex chronicus and its variants, prurigo nodularis, lichenificatio gigantea, and certain phases of the Sulzberger-Garbe syndrome. We intend, furthermore, to point out that these processes are frequently related to some emotional disturbance. In addition, we shall emphasize that the diagnosis of such psychogenically induced dermatoses often can be made by the clinician on the basis of positive dermatologic and histopathologic findings, rather than by resorting to the negative criterion of exclusion. Without going into a detailed psychiatric explanation, we shall elucidate some psychodynamic mechanisms that may give rise to these cutaneous changes. Emotions are part of the basic hereditary equipment for adaptation. They represent the sensory component of visceral responses (mediated by way of the autonomic and endocrine References 1. Brunner, M. J.: Biologic Basis of Psychosomatic Disease of the Skin , Arch. Dermat. & Syph. 57:374 ( (March) ) 1948. 2. Seitz, P. F. D.: An Experimental Approach to Psychocutaneous Problems , J. Invest. Dermat. 13:199 ( (Oct.) ) 1949. 3. Miller, M. L.: Psychodynamic Mechanisms in a Case of Neurodermatitis , Psychosom. Med. 10:309 ( (Nov.) -Dec.) 1948. 4. Stokes, J. H., and Beerman, H.: Psychosomatic Correlations in Allergic Conditions: A Review of Problems and Literature , Psychosom. Med. 2:438 ( (Oct.) ) 1940. 5. Cormia, F. E.: Psychosomatic Factors in Dermatoses , Arch. Dermat. & Syph. 55:601 ( (May) ) 1947. 6. Cannon, W. B.: The Wisdom of the Body , ed. 2, New York, W. W. Norton & Company, Inc., 1939. 7. Selye, H.: Textbook of Endocrinology , Montreal, Acta Endocrinologica, Inc., 1947, p. 837. 8. Klauder, J. V.: Psychogenic Aspects of Skin Diseases , J. Nerv. & Ment. Dis. 84:249 ( (Sept.) ) 1936. 9. Wright, C. S.: Psychosomatic Factors in Dermatology , South M. J. 42:951 ( (Nov.) ) 1949. 10. English, O. S.: Role of Emotion in Disorders of the Skin , Arch. Dermat. & Syph. 60:1063 ( (Dec.) ) 1949. 11. Seitz, P. F. D.: Psychocutaneous Aspects of Persistent Pruritus and Excessive Excoriation , A. M. A. Arch. Dermat. & Syph. , to be published. 12. Michelson, H. E.: Psychosomatic Studies in Dermatology , Arch. Dermat. & Syph. 51:245 ( (April) ) 1945. 13. Seitz, P. F. D.: Psychogenic Conditioning During the First 2 Weeks of Life , Psychosom. Med. 12:187 ( (May) -June) 1950. 14. Rothman, S.: The Role of the Autonomic Nervous System in Cutaneous Disorders , Psychosom. Med. 7:90 ( (March) ) 1945. 15. Lynch, F. W.: Suboccipital Dermatitis , Arch. Dermat. & Syph. 60:307 ( (Sept.) ) 1949. 16. Sachs, W.; Miller, C. S., and Gray, M. B.: Neurodermatitic Reaction , Arch. Dermat. & Syph. 54:397 ( (Oct.) ) 1946. 17. Ormsby, O. S., and Montgomery, H.: Diseases of the Skin , ed. 7, Philadelphia, Lea & Febiger, 1948, p. 360. 18. Laymon, C. W., and Dixon, A. A.: Lesions of the Scalp in Certain Scaly Dermatoses: Histologic Study , Arch. Dermat. & Syph. 62:181 ( (Aug.) ) 1950. 19. Berlin, C.: Lichenificatio Gigantea (Lichénification Géante of Brocq and Pautrier) , Arch. Dermat. & Syph. 39:1012 ( (June) ) 1939. 20. Ronchese, F.: Neurodermatitis with Giant Lichenification , Arch. Dermat. & Syph. 43:920 ( (May) ) 1941. 21. Sulzberger, M. B., and Garbe, W.: Nine Cases of a Distinctive Exudative Discoid and Lichenoid Chronic Dermatosis , Arch. Dermat. & Syph. 36:247 ( (Aug.) ) 1937. 22. Schneider, E., and Kesten, B.: Polymorphic Prurigo: A Psychosomatic Study of 3 Cases , J. Invest. Dermat. 10:205 ( (March) ) 1948. 23. Sachs, W., and Kirsch, N.: Exudative Discoid and Lichenoid Chronic Dermatosis (Sulzberger-Garbe): Histopathologic Study , J. Invest. Dermat. 8:215 ( (April) ) 1947.

Journal

A.M.A. Archives of Dermatology & SyphilologyAmerican Medical Association

Published: Sep 1, 1951

References