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Dermatology as a specialty lends itself to discussions of morphological structure, since that is the most obvious factor. As a result, the nosology of cutaneous diseases is based essentially on descriptive terminology. With the advent of the microscope, our knowledge of the etiology of some cutaneous diseases was greatly augmented through studies of bacteriology, mycology and pathology. More recently, biochemistry, allergy, endocrinology and dietetics have greatly added to our knowledge. However, in spite of the development of these various studies, it was felt that there was, and still is, a large gap in our understanding of skin diseases. For example, why was the elimination of an allergen insufficient to clear up an allergic manifestation? Why did a patient react to an allergen at one time and not react at another time? Similar questions could be asked in the fields of bacteriology and mycology. Emotional factors explain many of these gaps. Any physician who has observed patients, or has himself been ill, will recognize to what extent illness will fluctuate in proportion to the emotional state of the patient, and, by the same token, there will be an emotional reaction to the illness itself. This paper will present essentially the relationship of emotional factors as contributing to the etiology of certain cutaneous entities.
The skin heretofore has been considered an outer covering of the body which was acted upon passively by external and/or internal factors, rather than as an integral organ of the body with functions of its own. Actually the skin is the largest organ of the body with very important functions. Embryologically, the skin (including its appendages, hair and nails) and the central nervous system originate from the ectoderm, so that their relationship is a very close one. Anatomically, the skin is both a barrier and interagent between the individual and his environment. It is also the end organ for a