The role of lipids in vitiligo and schizophrenia.

The pathogenesis of vitiligo and schizophrenia has not been adequately clarified. We explore the role of lipids in these diseases. Both conditions have been associated with stress in several observations and studies. Research data indicate complex interactions between oxidative stress and metabolic syndrome-with lipid abnormalities being a significant component of the latter-in these diseases. The impaired membrane lipid homeostasis mechanism is related to the increased phospholipid remodeling caused by excessive oxidative stress in schizophrenia. We indicate that sphingomyelin is possibly involved in the pathogenesis of these diseases. Statins have anti-inflammatory and immunomodulating effects and an effect against oxidative stress. Preliminary clinical studies show that these agents may be beneficial in both vitiligo and schizophrenia, but their therapeutic value should be studied further.

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.

Psychodermatology of acne: Psychological aspects and effects of acne vulgaris.

INTRODUCTION: Acne is a chronic inflammatory skin condition seen commonly in adolescence and young adulthood. Despite being a frequent and nonthreatening life condition, acne has a significant psychological impact and comorbidity. AIMS: This review will describe prevalence, common clinical features, different clinical presentations, differential diagnoses, and treatment recommendation. Special focus has been put on psychological aspects. METHODS: We conducted a literature search on PubMed from January 2001 to June 2020 with the search terms of Acne vulgaris, psychological, adolescents, anxiety, suicide, mood disorders. Reference lists of identified articles were examined for further relevant studies. The search was limited to English language articles. No specified quality criteria were used for study inclusion. RESULTS: The clinical manifestations of acne are very important in the differential diagnosis and its psychological implications. CONCLUSION: Through this article, we conclude that despite being a frequent and nonthreatening life condition, acne has a significant psychological impact which requires effective treatment to improve the patient's skin and self-esteem.

Nonpharmacological treatment approach in trichotillomania (hair-pulling disorder).

Trichotillomania (TTM) is a fairly common psychodermatological disorder. This is characterized by recurrent urges to pull hair from hair-containing parts of the body and produces bald patches on scalp. Besides scalp, eye lashes, eyebrows, and pubic area may be involved. Clinically two types are recognized, the automatic and focused types. Currently, this is classified into obsessive- and compulsive-related disorder. Most common psychiatric manifestations include anxiety, depression, and low self-esteem. It has bimodal distribution in children and adolescents and adults. No recognized treatment is available. Pharmacological treatment is based on limited trials and case reports. Psychotherapies are mainstay of treatment. This review mainly focuses on evidence-based psychotherapeutic techniques used in the treatment of TTM.

Psychotropic drugs in dermatology: A dermatologist's approach and choice of medications.

Psychiatric symptoms in dermatology practice are increasingly being recognized. The use of psychiatric medications by dermatologist is dealt with caution and uncertainty in several psychodermatological conditions. Several skin conditions are associated with anxiety, depression, and obsessive-compulsive symptoms. Some conditions such as delusion of parasitosis require antipsychotic medication treatment. Keeping in mind the importance of psychotropic medications and its use in dermatology, following brief review will familiarize dermatologists about the ease of understanding and prescribing psychotropic medications to help their patients with psychiatric symptoms and increase the compliance in treatment.

Psychological aspects of COVID-19.

BACKGROUND: COVID-19 pandemic has affected the world from every aspect. Individuals are drained from social, financial, and emotional percussion of this pandemic. Psychosocial consequences are far greater than are being perceived. It is anticipated that once the pandemic is over the psycho-emotional turbulence would shake the whole populations of affected countries. AIMS AND OBJECTIVES: To review the psychological consequences of COVID-19 pandemic. METHODS: A literature search was conducted on major databases from January 2020 to April 2020 with the search terms of Covid-19, Corona virus, psychological, depression, anxiety, phobias, obsessive behaviors, paranoia, parental relationship, marital life and maternal and fetal bond. CONCLUSION: Patients with COVID-19 infection are more likely to suffer from a myriad of psychological consequences, and this infection may have profound effect on parenting, relationships, marital life, elderly, and maternal-fetal bond.

Psychocutaneous disease: Clinical perspectives.

Psychocutaneous disease, defined in this review as primary psychiatric disease with skin manifestations, is commonly encountered in dermatology. Dermatologists can play an important role in the management of psychocutaneous disease because patients visit dermatology for treatment of their skin problems but often refuse psychiatric intervention. This review describes common psychocutaneous syndromes, including delusional, factitious, obsessive-compulsive and related, and eating disorders, as well as psychogenic pruritus, cutaneous sensory (pain) syndromes, posttraumatic stress disorder, and sleep-wake disorders. The updated classification of these disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition is included. Strategies for management are reviewed.

Psychocutaneous disease: Pharmacotherapy and psychotherapy.

Building a strong therapeutic alliance with the patient is of utmost importance in the management of psychocutaneous disease. Optimal management of psychocutaneous disease includes both pharmacotherapy and psychotherapy. This article reviews psychotropic medications currently used for psychocutaneous disease, including antidepressants, antipsychotics, mood stabilizers, and anxiolytics, with a discussion of relevant dosing regimens and adverse effects. Pruritus management is addressed. In addition, basic and complex forms of psychotherapy, such as cognitive-behavioral therapy and habit-reversal training, are described.