key: cord-0998249-zabzhbv6
authors: Hafi, Bishurul; Uvais, NA; Jafferany, Mohammad; Afra, TP; Muhammed Razmi, T
title: Impact of Covid 19 pandemic on obsessive compulsive and related disorder patients‐ Psychodermatological perspectives
date: 2020-05-30
journal: Dermatol Ther
DOI: 10.1111/dth.13736
sha: 38d51bfdf2a80a73658d082aa37f47272153b388
doc_id: 998249
cord_uid: zabzhbv6

nan

The burden of OCRD in dermatology patients is considerably high. Of the many domains of OCDR symptoms, obsessions of contamination and compulsive hand washing are amongst the commonest. Many such patients present to dermatology OPDs with hand eczema and psychodermatologists may be the primary health care provider to these patients. Covid 19 crisis has the potential to exacerbate the symptom while they may get unprecedented moral support from the family and society for the same. It has been noted that, though this symptom respond well to combination of pharmacotherapy and psychotherapy, relapse is imminent if subjected to stress due to external or environmental cues. 2 The importance of hand hygiene in destroying virus gives a cognitive justification to the patients. Non practicality of commonly employed cognitive behavioural therapy (CBT) method exposure and response prevention (ERP) makes This article is protected by copyright. All rights reserved. Addition of a low dose antipsychotic can be considered in resistant cases. Trained clinic ia ns can offer other less evidence-based forms of CBT not involving ERP, such as imagina l exposure or danger ideation reduction therapy, which will be less risky during the pandemic.

We should remember that other conditions in OCRD, as defined by DSM 5, such as trichotillomania, psychogenic excoriation and onychophagia can also be aggravated proportionately to the stress level. 4 Moreover the information about skin manifestations of Covid-19 infection has become popular among public and we are witnessing an increased anxious enquiries regarding the same from our patients. 5 Perniosis lesions are being mistaken for reported 'Covid toe' by many. This can cause significant obsession and hypochondrias is This article is protected by copyright. All rights reserved.

(which has been recently endorsed as a OCRD in the World Health Organisation ICD-11), which further illustrates the role of psychodermatologists during the pandemic. 6 

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Coronavirus Disease-2019 with Dermatologic Manifestations and Implications: An Unfolding Conundrum