Approximately half of all patients presenting to dermatologists exhibit signs 
and symptoms of psychiatric conditions that are either primary or secondary to 
cutaneous disease. Because patients typically resist psychiatric consult, 
dermatologists often are on the front line in evaluating and treating these 
patients. Accordingly, distinguishing the specific underlying or resulting 
psychiatric condition is essential for effective treatment. The etiology, 
epidemiology, clinical presentation, diagnosis, and first-line treatment of 
specific primary psychiatric causes of dermatologic conditions, including 
delusional infestation, Morgellons syndrome, olfactory reference syndrome, body 
dysmorphic disorder, excoriation disorder, trichotillomania, and dermatitis 
artefacta are discussed here, followed by a discussion of the recommended 
treatment approach with an overview of the different first-line therapies 
discussed in this review, specifically cognitive behavioral therapy, atypical 
antipsychotics, selective serotonin reuptake inhibitors, and tricyclic 
antidepressants. Included is a guide for dermatologists to use while prescribing 
these medications.