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The psychogenic dermatoses form a mooted borderland of dermatology and psychopathology. While, on the one hand, psychiatrists like Bunnemann (1), Stern (2), Homburger (3), Kronfeld (4), and Bettmann (5), and psychoanalysts like Stekel (6), Guthiel (7), and others consider the psychogenesis of certain skin diseases as proven, dermatologists are more cautious in expressing their opinion and advise care in the evaluation of the clinical aspects of such diseases. However, we also find scientists, foremost among them being W. Th. Sack (9-12), who convincingly defend the psycho-genesis of certain skin conditions.
Sack has tersely subdivided the dermatoses into two classes— pruriginose and non-pruriginose. This classification is useful because only the first group—the pruriginose dermatoses—is discussed in this paper and we wish to confine ourselves to the psychogenesis of pruritus vulvae. We are referring to the “essential” pruritus (Olshausen) and are excluding all symptomatic forms from our observation (that is to say, pruritus that may occur in cases of diabetes, intestinal parasites, uric acid diathesis, cholemia, icterus, gynecologic affections, the leukoplakias as described by Labhardt (13) and Singer (14) and many others).
As far as the pruritus is concerned, the psychic condition and influence are plainly evident and easily understood. Even J. K. Mayr (15), who expresses himself rather sceptically in a collective report about the problem of the psychogenic dermatoses, is inclined to admit that “in certain causes of itching” a psychogenesis was “the most likely.”
But as far as the pruritus vulvae is concerned, a third branch of medicine, gynecology, is duly qualified for its scientific solution. Olshausen considers pruritus vulvae as a “neurosis caused by obesity