TY  - CHAP
M1  - Book, Section
TI  - Chapter 149. Self-Inflicted Dermatoses
A1  - Usatine, Richard P.
A1  - Smith, Mindy A.
A1  - Chumley, Heidi S.
A1  - Mayeaux, E.J.
Y1  - 2013
N1  - 
T2  - The Color Atlas of Family Medicine, 2e
AB  - A  55-year-old  woman  presents  with  severe  itching  on  her  arms  and  legs.  The  itching  disrupts  her  sleep  and  she  sometimes  scratches  her  arms  and  legs  until  exhaustion  (Figures  149-1  and  149-2).1  She  had  used  moisturizers,  emollients,  and  topical  corticosteroids,  but  they  only  alleviated  the  itching  temporarily.  The  itching  began  10  months  earlier  after  finalizing  the  divorce  from  her  husband  of  20  years.  The  patient's  right  leg  had  been  amputated  above  the  knee  after  a  car  accident,  and  she  now  wore  a  prosthetic  leg.  The  patient  readily  admitted  to  a  great  deal  of  psychological  distress.  She  described  feeling  depressed  since  her  divorce,  and  the  loss  of  her  leg  further  aggravated  her  situation.  She  has  had  difficulty  securing  a  job  and  had  high  anxiety  about  being  able  to  pay  for  rent  and  bills.  The  diagnosis  made  was  neurotic  excoriations  (neurodermatitis)  and  the  patient  understood  that  she  was  doing  this  to  her  own  skin.  The  patient  improved  with  nail  cutting,  acknowledging  the  self-inflicted  nature  of  her  excoriations  and  topical  clobetasol.  One  year  later,  the  patient  was  working  in  the  hospital  laboratory  with  a  tremendous  improvement  in  her  skin  condition  (Figure  149-3).  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/18
UR  - accessmedicine.mhmedical.com/content.aspx?aid=57679702
ER  -