skin changes , stress and ptsd

7/30/2019 Skin changes , stress and PTSD

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INCIDENCE OF SKIN

MANIFESTATION IN PATIENTS WITHPOSTTRAUMATIC STRESS

DISEASE

Department of dermatovenereolgy,General hospital Karlovac, Karlovac, Croatia

CvitanoviH, Kuljanac I, JaniE, AnziSA


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Psychologic factors contribute in etiology

of about 25% of all dermatosis. Number or

patients with posttraumatic stress disease

increases in period after the War in

Croatia (1991-1995), many of them have

skin disease and seek for comprehensive

medical care.


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Aim of this paper is to establish incidence

of skin comorbidity in specific population of


and to compare incidence of immediate

postwar period and late post war period.


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We used electronic data base of General

hospital Karlovac.

Statistic analyse was performed by Excell

Microsoft.


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Results.

In immediate postwar period (1996-2005)

number of patients with posttraumatic

stress disease was 424 (0,28%) of overall

150316 dermatologic patients.


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There were 383 (90.33%) men, and 41

(9.67%) women.


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Distribution according sex

90%

10%

men

women


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In late post war period (2011) number of


in was 24 (0,13%) of overall 18062

patients.


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There were 13 (54,17%) men and 11

(45,83%) women.


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Distribution according sex

54,17%

45,83% men

women


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Gender (male/female) ratio change form

9:1 to 1,18 in late post war period


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Incidence skin diseases of patients with

posttraumatic stress in immediate post war

period was 0,28%.

It was statistically significant higher than

incidence of 0,13% in late postwar period.


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INCIDENCE OF SKIN MANIFESTATION IN PATIENTS WITHPOSTTRAUMATIC STRESS DISEASE

0,28

0,13

0

0,05

0,1

0,15

0,2

0,25

0,3

0,35

0,4

Immediate postwar period Late postwar period

incidence


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The most common dermatologic disease

was contact allergic and irritative

dermatitis in 26.29% patients, then

psoriasis in 18.4%, dyshidrosis in 10.4%and dermatitis seborrhoica in 9.43%.


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Ptsd population

Eczema 26.9%

Urticaria 4.0%

Pruritus 3.8%

Atopic dermatitis

3.77%

Psoriasis 18.4%

General population

Eczema 9.2%

Urticaria 0.72%Pruritus 1.7%

Atopic dermatitis

0.72%Psoriasis 3.4%


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The most common dermatologic disease

of patients with posttraumatic stress

disease comparing two periods were the

same: contact dermatitis followed bypsoriasis.


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The most common dermatoses in patients with PTSD

0

10

2030

40

50

60

70

80

90

derm

atitise

conta

ctuall

derm

atitiseco

ntactu

dyshid

rosis

psoria

sis

derm

atitis

seb

orrhoica

urtic

aria

derma

titis

ato

pica

pruritu

s

kerato

sissebo

rrho

ica

gran

ulomaan

nula

re

rosa

cea

patients


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Conclusion

Stress as important factor in developingpsoriasis in known for many years and ourresults support it. Dermatitis seborrhoica

and dyshidrosis are more common inpeople with neurotic character.Generalised pruritus and atopic dermatitisare diseases where stress is important in

trigering or worsening illness.


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High incidence of contact allergic andirritative dermatitis in patients withposttraumatic stress disease can be linked

with depression and anxiety but also weexplain high incidence of allergic andirritative dermatitis by the fact that most ofthem before the War worked in steel and

agriculture industry.


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Early diagnosis of comorbidity can helpfaster and better treatment and preventingserious worsening of quality of life and

basic psychiatric disease.The importance of psychic factorsincreased especially in past years and thataspects must be obligatory part of anydermatologic diagnostic and therapeuticapproach.


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Trends in incidence show changes from

war caused posttraumatic stress disease

to major life stress events etiology.

There are significant fall in incidence of

patients with skin changes and

posttraumatic stress disease and also

significant gender (male/female) ratiochange.

skin changes , stress and ptsd

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