Through the looking glass: Skin signs that help diagnose eating disorders.

Eating disorders (EDs) such as anorexia nervosa and bulimia nervosa have a plethora of skin manifestations. They can be categorized into skin signs of self-purging, skin signs of starvation, skin signs related to drug abuse, skin signs of psychiatric comorbidity, and miscellaneous signs. "Guiding signs" are valuable because they are pointers to the diagnosis of an ED. They include hypertrichosis (lanugo-like hair), Russell's sign (knuckle calluses), self-induced dermatitis, and perimylolysis (tooth enamel erosion). Practitioners should recognize such skin signs promptly, as this helps to diagnose early, which may improve the prognosis of ED. Management requires a multidisciplinary approach that focuses on psychotherapy combined with attention to medical complications, nutritional needs, and nonpsychiatric findings such as cutaneous manifestations. Psychotropic medications that are currently used in EDs include pimozide and atypical antipsychotic agents, such as aripiprazole and olanzapine, fluoxetine, and lisdexamfetamine.

Antihistamines in Psoriasis.

Psoriasis is polygenic, interleukin (IL)-17 and IL-23 driven chronic relapsing inflammatory multisystem disease caused by a complex interplay of endogenous and environmental factors. The most common and distressing symptom in psoriasis is itch, adding significantly to the burden of disease. Although histamine has historically not been considered a key itch mediator in psoriasis, there is some evidence from the literature that antihistamines may be effective to reduce itch in psoriasis. This review focuses on the role of antihistamines in the management of itch in psoriasis. The literature search included peer-reviewed articles published in English language (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) until January 2021 and by reference lists of respective articles. J Drugs Dermatol. 2021;20(8):844-847. doi:10.36849/JDD.5966.

A Brief Review of Dermatitis Artefacta and Management Strategies for Physicians.

Dermatitis artefacta, an enigmatic entity with often bizarre and widely variable presentations, can be a challenge to diagnose and treat. Although it is classified as a primary psychiatric disorder, patients are often oblivious that the lesions are self-inflicted and thus consult a physician. Therefore, it becomes imperative to be aware of this condition and to build a good rapport with patients so as to counsel them on the need to seek care for their underlying psychiatric stressors. This narrative review focuses on reaching a proper diagnosis, addressing associated psychological morbidity, and formulating treatment approaches.

Cosmetic Presentations and Challenges of Body Dysmorphic Disorder and Its Collaborative Management.

In recent times, there has been a huge surge in the demand for cosmetology. However, not every patient is an ideal candidate for cosmetic interventions, and this needs to be carefully evaluated at outpatient visit. Various patients have underlying undetected psychiatric co-morbidities which prompt them to seek cosmetic care. One such condition is body dysmorphic disorder in which patients are present with marked anxiety which seems out of proportion to their apparently trivial complaints. These patients are also often unsatisfied with their cosmetic outcome, sometimes turning violent or pressing legal charges against their treatment providers. It is therefore of utmost importance for dermatologists and cosmetic surgeons to be aware of this condition and work in liaison with psychiatrists to provide holistic care to these patients. A literature search of PubMed-indexed journals using keywords "body dysmorphic disorder," "BDD in dermatology," and "BDD in cosmetic surgery" was carried out from the year 2000 up to date for this review.

"The unfair drive to be fair": Psychosocial aspects and implications of the use of skin lightening agents.

The quest to be fair is not a concept of the new world. For centuries untold, having a lighter skin tone has been considered as a trait of beauty and supremacy. Society implicates fairness as a factor for getting a prospective life partner. Media portrays fair skin tone as a predecessor for success. These subtle influences affect young minds and drive them towards wanting fair skin. Physicians observe that it is one of the most common forms of body dysmorphic disorder. This article aims to highlight the psychosocial factors that mold this mentality and the possible ill effects it can have on a person, both psychologically as well as physically.

Low-level laser therapy and narrative review of other treatment modalities in androgenetic alopecia.

Androgenetic alopecia (AGA), also termed as androgenic alopecia or common baldness, is a condition where there is androgen mediated conversion of susceptible terminal hair into vellus hair. Although it is reported more commonly in males, it also affects females but the incidence is relatively unknown. AGA tremendously affects the psychology of the patient due to its chronicity of treatment and cosmetic implications. There are numerous treatment options available for AGA but the choice of treatment has to often be tailored according to the patient's needs, affordability, and compliance. This review focusses on the various treatment options available, with special emphasis on the role of low-level laser therapy (LLLT) in the management of AGA. The literature research considered published journal articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) and reference lists of respective articles. Only articles available in English were considered for this review.