Stimulant use in patients presenting with psychocutaneous disorders

Background: Psychocutaneous disorders are often attributed to stimulant medications, yet this relationship has never been fully elucidated. Literature on psychocutaneous disorders largely focuses on clinical presentation and treatment rather than disease etiology or exacerbation. Objective: To determine whether patients presenting with psychocutaneous disorders display high rates of stimulant use and psychiatric comorbidity. Methods: We undertook a retrospective cohort study of patients with psychocutaneous disorders presenting to a single center. It was hypothesized that these patients would have high rates of stimulant use and psychiatric comorbidity. Following analysis of baseline demographics, the patients were assigned to 1 of 2 groups: those with a psychotic disorder and those with a neurotic disorder. Results: Sixty percent of the patients (n = 317) with psychocutaneous disease had recently used a stimulant and more than 80% (270 of 317) carried an additional psychiatric diagnosis. The neurotic disorder group (n = 237) was younger and had higher rates of stimulant use. The psychotic disorder group (n = 80) had higher rates of psychosis, medical comorbidity, and illicit stimulant drug use. Limitations: The predominantly Caucasian population may limit generalizability of findings as may the retrospective nature. Conclusions: Patients with psychocutaneous disease have high rates of stimulant use and most have at least 1 psychiatric comorbidity. ( J Am Acad Dermatol 2022;86:1002-9.)