A neglected but crucial aspect of skin function. A challenge for the 90s

Emotional dysfunction, child-family relationships and childhood atopic dermatitis

A link between atopic dermatitis (AD) and emotional dysfunction is now well established but consideration of this has yet to be widely incorporated into clinical management. A biopsychosocial model of the mind-body interaction is considered in conjunction with the theory of childhood emotional development and the impact of a diseased skin, for its effect on a child growing up with AD. AD inevitably adds to the difficulties of parenting, so that parents and children may become locked into dysfunctional relationships. This adds to the stresses for all concerned, and may contribute to the deterioration of the child's skin condition as part of a psychosomatic vicious cycle. There is a strong indication that the psychological dimensions of AD should be taken into account as part of routine management. Further research will be needed to establish the effectiveness of any psychological intervention.

Parental issues in the treatment of chronic infantile eczema

Infantile atopic eczema commonly responds readily to treatment. A subset of cases of intractable eczema improve dramatically when empathic understanding and parental education are added to conventional treatment.