Challenges of treating primary psychiatric disease in dermatology.

Psychiatric disorders are common among dermatology patients. They may be secondary to skin disease but also can be the primary cause of cutaneous concerns. Because patients with primary psychiatric disorders who present to dermatology often refuse referral to mental health providers, dermatologists are challenged with management of various psychiatric conditions, such as delusional infestation and trichotillomania. Effective, evidence-based treatments are available for psychodermatologic disorders, and dermatologists should be comfortable with their implementation.