The Difficult or Impossible-To-Treat Problem Patient

Abstract

One of the greatest challenges for a dermatologist is the patient who is difficult or even impossible to treat under somatic aspects. Usually, a primary underlying emotional disorder, such as acarophobia, artefacts, body dysmorphic disorder, or dermatoses with secondary profit from disease, is clearly and readily recognizable, even in the routine dermatological practice. The result is that adequate somatic therapy can hardly be performed. The characteristic and most frequently encountered problems that particularly occur in dermatology can be summarized as follows.