TY - CHAP M1 - Book, Section TI - Psychocutaneous Disorders A1 - Johnson, Anne E. A1 - Suzanne Fehr, Bettina A1 - Usatine, Richard P. A2 - Usatine, Richard P. A2 - Smith, Mindy A. A2 - Mayeaux, Jr., E.J. A2 - Chumley, Heidi S. PY - 2019 T2 - The Color Atlas and Synopsis of Family Medicine, 3e 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 155-1 and 155-2).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 physician diagnosed an "excoriation disorder," and the patient understood that she was doing this to her own skin. The patient improved with nail cutting, topical clobetasol, and acknowledging the self-inflicted nature of her excoriations. One year later, the patient was working in the hospital laboratory with a tremendous improvement in her skin condition (Figure 155-3). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - dermatology.mhmedical.com/content.aspx?aid=1164360230 ER -