Experiences of people with skin lesions with unclear origin
Research type
Research Study
Full title
Experiences of people with skin lesions with unclear origin.
IRAS ID
121458
Contact name
Reena Shah
Contact email
Research summary
People with skin lesions of unclear origin may fall in the category of artificial developed lesions. For example, dermatitis artefacta (DA) is a condition where individuals present with skin lesions in the absence of an underlying organic cause. Injuries are considered self-inflicted and a behaviour thought to help manage difficult emotions (Koblenzer, 2000). In clinical practice, dermatologists do not use the term dermatitis aftefacta and report it as skin lesions with unclear origin.\n\nCurrent management includes developing a doctor-patient relationship and medically treating the lesions. Although psychological therapy has been suggested (Shenefelt, 2005), dermatologists do not refer patients to psychology due to the current dogma, of not confronting the patients that their condition could be driven by psychological factors (Garcia, 2009; Koo, Ting and Ting, 2012). This dogma originates from research conducted in the 1970s which showed that confrontation resulted in loss of therapeutic relationship. However there were limitations to this study as it did not explore systematically at the issues of confrontation and the papers were predominately case reports. \n\nIt is hypothesised that if a good doctor-patient relationship is built up over time and there is access to a psychologist then referral to psychology may eventually be accepted by the patient (Ahmed, Shah, Bewley, 2013). The patient’s denial of the psychological distress and negative feelings aroused in healthcare professionals can make management difficult. However, it can be possible overtime if a sufficiently supportive environment can be established. \n\nThis study aims to gain a better understanding of this condition from patients and from dermatologists who treat people with this condition. The main aim is to gather clinical information about the characteristics of those with the condition and how they are currently managed in order to develop more appropriate interventions to meet the patient’s needs
REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
14/WM/0069
Date of REC Opinion
19 Feb 2014
REC opinion
Favourable Opinion