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首页> 外文期刊>Clinics in dermatology >Emotional regulation, dissociation, and the self-induced dermatoses: Clinical features and implications for treatment with mood stabilizers
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Emotional regulation, dissociation, and the self-induced dermatoses: Clinical features and implications for treatment with mood stabilizers

机译：情绪调节，解离和自我诱导的皮肤病：临床特征及其对情绪稳定剂治疗的意义

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The self-induced dermatoses (such as trichotillomania, pathologic skin picking or neurotic excoriations, dermatitis artefacta, onychophagia and onychotillomania), which are caused as a result of excessive manipulation of the skin, hair, and nails by the patient, can contribute to significant morbidity and can even complicate the course of a primary dermatologic condition such as acne (eg, in acne excori??e) and some pruritic dermatoses. Reports on the self-induced dermatoses in the past decade have tended to focus upon the specific motor behaviors involved in self-inducing the lesions (ie, skin picking or hair pulling) rather than address the common psychopathologic factors underlying the self-injurious behaviors. In the current psychiatric nosology (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) the self-induced dermatoses are classified as Impulse Control Disorders and Stereotypic Movement Disorders, and this classification does not adequately consider the fact that in most patients with self-induced dermatoses, the frequency and severity of the self-injurious behaviors are directly related to acute or chronic problems with emotional regulation and dissociation. This may be part of the reason that there is a relative paucity of effective treatments for these disorders. The skin and its appendages are well innervated with a dense network of afferent sensory nerves and efferent autonomic nerves, and the integumentary system is frequently the focus of tension-reducing and emotion-regulating behaviors, especially during states of autonomic nervous system hyperarousal. This factor is important in the pathogenesis of the self-induced dermatoses. Mood-stabilizing agents, such as lithium carbonate, that are used to treat disorders of emotional regulation have not been adequately studied in the management of the self-induced dermatoses and may prove to be very helpful in the management of these disorders. ? 2013 Elsevier Inc.
机译：由于患者过度操作皮肤，头发和指甲而导致的自我诱发的皮肤病（例如毛滴虫病，病理性皮肤采摘或神经性皮屑，人工皮肤炎，甲癣和甲癣）可导致显着的皮肤病。发病，甚至会使原发性皮肤病（例如痤疮（例如痤疮））和一些瘙痒性皮肤病的病程复杂化。在过去的十年中，关于自我诱导的皮肤病的报道倾向于集中于自我诱导的病变所涉及的特定运动行为（即，摘皮或拔头发），而不是针对造成自我伤害行为的常见心理病理因素。在当前的精神病学类别（《精神疾病诊断和统计手册》，第四版，文本修订）中，自我诱发的皮肤病被分类为“冲动控制障碍”和“刻板印象运动障碍”，这种分类没有充分考虑到以下事实：自我诱导的皮肤病，自我伤害行为的频率和严重程度与情绪调节和分离的急性或慢性问题直接相关。这可能是这些疾病缺乏有效治疗的部分原因。皮肤及其附肢被传入的感觉神经和自主神经传出的密集网络很好地支配，并且皮层系统通常是减轻紧张和调节情绪的行为的焦点，特别是在自主神经系统过度兴奋的状态下。该因素在自我诱导的皮肤病的发病机理中很重要。用于治疗情绪调节障碍的情绪稳定剂（例如碳酸锂）在自我诱导的皮肤病的治疗中尚未得到充分研究，可能证明对这些疾病的治疗非常有帮助。 ？ 2013爱思唯尔公司

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