Karl Menninger here reports his observations and reactions during six weeks spent in the Dermatological Section of the Mayo Clinic. He stresses the importance of shame reactions, the agony of itching and the fact that the sufferings of skin patients are vastly underestimated. A great percentage of dermatological practice is made up of illnesses which are predominantly, or at least significantly, determined by psychological factors. Unfortunately, the dermatologist is too busy to devote enough time to the psychological problems of his patients and until now psychiatrists have not studied enough of these problems, under research conditions and with thorough analysis, to promote a successful coöperative effort.