THE PURPOSE of this report is to present certain clinical impressions which have been formulated as a result of psychiatric study and treatment of 120 patients with persistent pruritus and excessive excoriation. Several diagnostic categories were represented in this group: lichen simplex chronicus, pruritus ani et vulvae, disseminated neurodermatitis, and so-called "neurotic excoriations." The differences between these various disorders will not be dealt with in this report. Attention will be directed instead to the features of similarity, viz., the psychocutaneous aspects of persistent pruritus and excessive excoriation.
THE SURFACE ASPECTS OF COMPOSURE
One of the earliest impressions gained in this study had to do with the appearance and behavior of these patients. When first seen in a clinical setting patients with persistent pruritus and excessive excoriation do not appear to be tense or "nervous." They usually exhibit a surface appearance of composure. This emotionally undemonstrative behavior is maintained throughout the initial interviews, giving a deceptive impression of equanimity. The
PHILIP F. DURHAM SEITZ. PSYCHOCUTANEOUS ASPECTS OF PERSISTENT PRURITUS AND EXCESSIVE EXCORIATION. AMA Arch Derm Syphilol. 1951;64(2):136–141. doi:10.1001/archderm.1951.01570080020003