Self-evaluation of acne and emotion: a pilot study.
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Biomedical subjects
Publications and source records attributed to R M Handler.
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Psychosomatic dermatology is practiced in some manner by every dermatologist. In spite of this, there has been a virtual void in the literature from the middle 1950s until the present time. The relationship to physiologic phenomena, as well as a classification of psychosomatic dermatology, is reviewed. Dermatologic patients are divided into three groups: the primary group in which the emotional disorder is the primary disease and the cutaneous disorder merely part of its expression; the secondary group in which the basic cause is organic but does not affect the person emotionally in various degrees; and the collaborative group in which the organic causes and emotional disorders combine in different degrees to cause the skin disorder. This paper discusses anxiety and depression along with methods of dermatologic psychosomatic therapy consisting of antianxiety drugs, especially the benzodiazepines, antidepressants, hypnosis, behavior therapy, and the doctor/patient rapport. We conclude that one of the objectives for every dermatologist is to treat the entire patient-the psyche along with the soma.
With the advent of various new methods of treating psoriasis, it is necessary to remind physicians to consider an agent that is easy to administer, locally effective, relatively inexpensive, not time-consuming and without systemic toxic effects. Nineteen patients were treated with topical nitrogen mustard between 1972 and 1976, and only five developed sufficient contact sensitization to warrant stopping medication.
In multicentric clinical trial involving twelve investigators and 271 patients, betamethasone dipropionate (0.1 percent) aerosol was found to be significantly more effective than its vehicle in the treatment of moderate to severe contact dermatitis. Statistical tests determined this significance at a value of less than 0.0001. Betamethasone dipropionate was favored numerically not only in the combined results but also in ten of the twelve individual centers.
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The effectiveness and safety of fluocinonide 0.05% in a cream base (FAPG cream: fatty acid propylene glycol) were evaluated in 105 patients with recalcitrant corticosteroid-responsive dermatoses that had failed to respond adequately to at least two weeks' previous treatment with one of 21 other topical corticosteroid preparations. At the end of the three weeks, 66 (71.0%) of the 93 patients who qualified for analysis showed excellent to moderate improvement with fluocinonide. Side effects were rare and of a minor nature. The general effectiveness of fluocinonide is indicated in this single-blind trail in which excellent or moderate results predominated in 8 of the 12 different diagnosis.
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