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This paper is based on studies carried out at New York University on cases from the skin ward of Bellevue Hospital, New York. Its purpose is to establish the relation of emotional to genetic and external factors in the ætiology of dermatoses, with the hypothesis that, in some, emotional factors might be predominant. I chose as method the analysis of representative cases of an entity, followed by extensive interviews and narcoanalysis of a large number.
The entity I am discussing affects only men, starting in the mid-thirties. The chief complaint is of crises of maddening itch, mainly at night. Starting nearly always on the penis, it spreads to the whole body. Besides permanent lesions, which are first exudative-discoid, then lichenoid, often resembling Mycosis fungoides, there is also an urticarial phase. Aetiology is quoted as unknown; the state is chronic, has its remissions, but is considered incurable.
Of the two analysed cases, I quote in greater detail one, still under treatment.
A thirty-seven-year-old office worker, sick and mostly hospitalized since the age of one and a half, one of the worst cases we had in our ward. His appearance was peculiar; tall, slightly under weight, posture over-erect or very sloppy, the face rigid, the eyes lacking normal motion, unable to talk freely or to associate. The incident precipitating the outbreak was: He had saved $200, which his wife wanted to lend to her father. Faced with the choice between 'giving up his security' and hurting his father-in-law and his wife, he gave in after endless arguments, but felt terrible about it. After a few days he had the first lesion on his penis, soon followed by generalization.
After some sessions came a confession: 'I got it on my hands because I have stolen—on my penis because I was unfaithful.' Years ago he had stolen money meant for the Infantile Paralysis Fund. Why? 'He needed it for his security.'
His complaints now shifted to his eyes. They did not move freely, especial