Simmich T, Traenckner I, Gieler U
Klinik und Poliklinik für Psychotherapie und Psychosomatik am Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden.
Hautarzt. 2001 Aug;52(8):712-6. doi: 10.1007/s001050170087.
Intolerance reaction of the skin refers to multiple reaction patterns, including toxic, allergic, pseudo-allergic and even psychiatric mechanisms. In our case, a patient was diagnosed for years as having "multiple allergies", but except for a documented contact allergy to a local anesthetic, her underlying disease was panic disorder with multiple phobias. Using this case study with one year follow-up, hypotheses are discussed about effective psychotherapy in patients with intolerance reactions of the skin. Differential indications are explored with reference to the latest investigative results in psychoneuroimmunology. In this patient, psychotherapy helped the phobias and eliminated her conviction that she had multiple allergies. In addition, the positive pre-therapy allergy testing was not reproducible. The dermatologist should not expect such patients to present with phobias, because they frequently shift their phobic anxiety into the fear of allergic reactions to escape from the label of having psychiatric disease. Such patients should receive psychotherapy if they begin to generalize their avoidance behavior and limit their social contacts.
皮肤不耐受反应指多种反应模式，包括毒性、过敏、类过敏甚至精神机制。在我们的病例中，一名患者多年来被诊断为患有“多种过敏症”，但除了记录在案的对一种局部麻醉剂的接触性过敏外，她的潜在疾病是伴有多种恐惧症的惊恐障碍。通过这个为期一年随访的病例研究，探讨了针对皮肤不耐受反应患者有效心理治疗的假设。参考心理神经免疫学的最新研究结果探索了不同的适应症。在这名患者中，心理治疗帮助缓解了恐惧症，并消除了她认为自己患有多种过敏症的信念。此外，治疗前呈阳性的过敏测试结果无法重现。皮肤科医生不应期望此类患者表现出恐惧症，因为他们经常将恐惧焦虑转移到对过敏反应的恐惧上，以逃避患有精神疾病的标签。如果此类患者开始将其回避行为普遍化并限制社交接触，就应该接受心理治疗。
