skin changes , stress and ptsd
TRANSCRIPT
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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
patients with posttraumatic stress disease
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
patients with posttraumatic stress disease
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.