Can Rash be Caused by Mental State?

QUESTION: I recently visited my mother, who is suffering a depression since
my father died two months ago. I found her arms covered with crusty sores,
and she complained of fierce itching. My aunt says the rash is coming from
her mental state. Can that be true?
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ANSWER: Your aunt is on the right track, although it isn't a simple cause and
effect situation. As with all dermatological situations, it is difficult to
make a diagnosis without seeing the rash, but if they seemed to be in straight
lines on the outside or back of the arms, they would conform to a description
of a factitial dermatitis, or one that is produced by the patient herself,
usually unintentional. And that can be the case in certain conditions where
the stress of a recent loss can be the underlying cause for the beginning of
an intense itch or pruritus. This type of psychosomatic skin disease requires
an alert clinician to find the elements of the problem in a careful, complete,
case history when the characteristics of the rash provide the first clue. The
"rash" is really an excoriation or a hollowed out area caused by scratching,
rubbing or picking. As part of the healing process, a crust is formed to
protect the underlying tissue, but frequently that too is picked away. Your
mother needs the reassurance of her physician that all will be well, and
perhaps a tranquilizer and a bland cream to place on her sores. All will be
well, but it make take up to 6 months to achieve.