Koblenzer - Psychocutaneous Disease Classification

Examples include:

• delusions of parasitosis;
• skin disorders in which psychogenic factors are imputed (rosacea falls into this category);
• skin disorders dependent on genetic factors whose course is often affected by stressful skin conditions.

There is an overlap between all three categories.

Secondary psychiatric problems such as social anxiety disorder, depression and dysmorphophpbia, resulting from an individual's perception of a primary dermatologic condition, should not be excluded when rosacea patients present with psychological distress.

Rosacea patients often continue to be distressed and dissatisfied with their skin's treatment even when their condition appears to be improving from a medical point of view using more subjective criteria for evaluation.

This is a real problem, because rosacea patients will often discontinue an effective treatment for emotional reasons.

Keeping photographic records of progress should lessen the number of rosacea sufferers who abandon treatment on these grounds. Properly used, such records can only serve to enhance rosacea treatment outcomes by helping patients deal with the concrete realities of their skin's condition.