ABSTRACT
Patients with certain psychiatric diagnoses seek dermatological care as a means of denying their psychopathology. In the majority of cases these patients have delusions. A delusion is a false, unshakeable idea or belief that is out of keeping with the patient’s educational, cultural, and social background. The patient holds this belief with the same conviction and intensity as he holds other nondelusional beliefs about himself. Subjectively, a delusion is a belief. The deluded person is usually extremely irritated by any logical argument or evidence that is presented contrary to the belief (1). Therefore, these patients are usually difficult to assess and treat. This chapter focuses on 1) the symptomatology of delusional disorder as it relates to the dermatologist, 2) the differential diagnosis, 3) the approach to the patient, and 4) nonpharmacological and pharmacological treatment.
