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As a dermatologist with a growing practice, Caroline Koblenzer became frustrated at her inability to treat, or even successfully refer, a significant group of patients. You know the territory: Mrs Jones gives you daily reports on how many cockroaches the Martians have put in her hair. The whole Scarlet family uses the creme you prescribe, stopping only when it starts to work. Nothing seems to help Mr Green's psoriasis except his overbearing mother's leaving town. Janey Brown's hair started falling out the day her parents separated. Ronnie White's acne is mild until he goes into a rage and excoriates it.
The harried practitioner could be left wondering if some prankster has changed the shingle from "Dermatology" to "Mental Hospital." Welcome to the twilight zone of psychocutaneous medicine. There is no road map—but we now have a new guidebook.
Koblenzer's response was a bold and unusual one. She underwent formal training
Ted A. Grossbart. Psychocutaneous Disease. Arch Dermatol. 1989;125(7):1023. doi:10.1001/archderm.1989.01670190157034