皮炎的治疗:系统综述

Mariah C. Estill, Mohammad Jafferany
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引用次数: 0

摘要

伪装性皮炎(DA)是一种罕见的皮肤心理疾病,其特征是患者否认是自己造成的皮肤损伤。皮炎给临床医生带来了复杂的临床挑战,因为患者通常对诊断有抵触情绪,对精神或心理服务的后续治疗也会犹豫不决。我们需要了解治疗 DA 患者的最佳方法。本系统性综述旨在填补这一知识空白:在 PubMed 和 Embase 上使用以下检索策略进行了检索:假性皮炎 OR 假性皮炎 OR 假性皮炎 OR 假性皮炎 OR 假性皮肤 AND 治疗 OR 管理 OR 治疗 OR 心理治疗 OR 药物治疗。纳入的研究均发表于同行评审期刊上,时间从开始至 2023 年 4 月 5 日,并讨论了皮炎的治疗和管理。本系统综述共纳入了 11 项回顾性或前瞻性研究。这些研究都发现DA的治疗具有挑战性,每项研究都报告了患者合并有精神疾病或相关的社会心理压力。总体而言,在由皮肤科医生、精神科医生和心理学家组成的多学科团队的精神皮肤病诊所接受治疗的随访患者的疗效较好。医学治疗有助于控制症状和促进伤口愈合,而心理和精神治疗则有助于解决该病症的潜在社会心理压力。需要进一步开展研究,以评估对 DA 患者的最佳管理和长期治疗效果。
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Treatment of Dermatitis Artefacta: A Systematic Review
Dermatitis artefacta (DA) is a rare psychocutaneous disorder characterised by self-inflicted skin lesions that the patient denies producing. DA poses a complex clinical challenge to clinicians as patients often are resistant to the diagnosis, and can be hesitant to follow up with psychiatric or psychological services. There is a need to understand the optimal approach for management of patients with DA. This systematic review was undertaken to address this gap in knowledge. A search was conducted on PubMed and Embase using the following search strategy: Dermatitis artefacta OR factitious dermatitis OR factitial dermatitis OR artefactual skin AND treatment OR management OR therapy OR psychotherapy OR pharmacotherapy. Included studies were published from inception to 5ᵗʰ April 2023 in peer-reviewed journals, and discussed the treatment and management of DA. Studies were excluded if they were published in a language other than English. A total of 11 retrospective or prospective studies were included in this systematic review. They all found DA to be challenging to treat, with every study reporting patients experiencing a comorbid psychiatric condition or associated psychosocial stressor. Overall, there were better reported outcomes among follow-up patients treated in psychodermatology clinics with multidisciplinary teams of dermatologists, psychiatrists, and psychologists. Medical treatments can help with symptom control and promote wound healing, while psychological and psychiatric treatments can help address underlying psychosocial stressors for the condition. Further research is needed to evaluate optimal management and long-term treatment outcomes in patients with DA.
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