Diagnosis in psychosomatic dermatology

Abstract

Franz Alexander 1 proposed that the term “psychosomatic” should be used only to indicate an investigative method for diagnosis and therapy with simultaneous and coordinated application of somatic (ie, physiologic, anatomic, pharmacologic, surgical, and dietetic) and psychological concepts and methods. Correct diagnostic methodology in psychosomatic dermatology could not, therefore, avoid subverting some of the procedures habitually used in medicine. In fact, in a traditional somatic approach the fundamental points are the progressive evaluation of the data resulting from the anamnesis, objective clinical examination of the patient, and the laboratory findings, from which diagnosis is deduced, by exclusion. 2 Dermatology—the science of evidence—has not subtracted itself from this interest aimed, above all, at “the apparent,” sometimes with scarce propensity for “what lies underneath,” what is not immediately in the foreground, what is not concretely evaluable.