CUTANEOUS MANIFESTATION SECONDARY TO PRIMARY PSYCHIATRIC ILLNESS

Abstract

Background: Cutaneous manifestations are among the most visible health concerns, often signaling underlying systemic or psychological conditions. Psychiatric illnesses are frequently associated with skin disorders due to shared pathophysiological pathways involving neuroendocrine and immune mechanisms. Despite global recognition of this link, there remains limited local data on the frequency and types of dermatologic presentations in psychiatric populations within South Asian contexts.

Objective: To determine the frequency and pattern of cutaneous manifestations in patients with primary psychiatric disorders attending a tertiary care hospital in Karachi.

Methods: This descriptive cross-sectional study was conducted at the Dermatology Department of Dow University of Health Sciences, Ojha Campus, Karachi. A total of 180 patients with established primary psychiatric illnesses for six months or more were enrolled through non-probability consecutive sampling. Participants aged 18–60 years underwent detailed dermatological examination by a qualified dermatologist. Demographic data and comorbid medical histories were recorded. Patients with sexually transmitted infections, substance abuse disorders, or who did not consent were excluded. Statistical analysis was performed using SPSS version 25.

Results: Among the 180 participants, 53.3% were female and 46.7% were male, with a mean age of 33.0 ± 8.6 years. The most prevalent psychiatric illness was anxiety disorder (47.2%), followed by depressive disorder (14.4%), schizophrenia (10.0%), bipolar disorder (9.4%), obsessive-compulsive disorder (9.4%), and post-traumatic stress disorder (9.4%). The leading cutaneous manifestation was acne excoriee (33.9%), followed by psoriasis (18.9%), psychogenic purpura (13.9%), neurotic excoriations (13.3%), delusion of parasitosis (10.0%), and both body dysmorphic disorder and dermatitis artefacta (5.0% each).

Conclusion: Cutaneous manifestations were found to be common among individuals with primary psychiatric disorders, with acne excoriee and psoriasis being the most frequently observed. These findings highlight the need for integrated psychodermatological care in clinical settings to improve holistic patient outcomes.