For over 3000 years doctors have wondered about how an individuals’ emotional state impacts on diseases of the skin and how the skin can reflect a persons’ emotional world. This area of study has been referred to as ‘psychodermatology’ or ‘psychocutaneous medicine’ by dermatologists and has been incorporated within the rubric of ‘somatic disorders’ or ‘psychosomatic medicine’ by those in the mental health field. The anecdotal and experimental literature in psychology and medicine strongly supports the hypothesis of a relationship between the psyche and the soma. Dermatology, perhaps more than most other disciplines, boasts a strong history in which these two concepts are interrelated. However, mental health professionals were only briefly integrated into dermatological practice during the past century. More recently, the study of the role the mind plays in diseases of the skin has resurfaced and there are now national and international societies devoted to this fascinating topic. Nevertheless, organized psychocutaneous medicine clinics are still relatively rare and the role that the psychodermatologist can play is still vague. This article will describe the types of patients that are seen in a psychodermatology clinic where an integrated treatment approach is used to treat many of the patients. In doing so, clinical issues that arise in the treatment of these patients will be discussed, the role a psychodermatologist plays will be elucidated, suggestions for how such a clinic can function optimally will be made, and the value of such an integrated program will be demonstrated. Preliminary data obtained over a 6-month period during the clinic’s operation reveal the wide range of patients who suffer from both dermatological and psychological illness. Many of these patients have complex psychological disorders that not only impact on their skin disease but create numerous obstacles to their being treated effectively. Through detailed case descriptions and analyses this paper attempts to describe the way one psychocutaneous medicine clinic is constructed and the role that a psychodermatologist can play in a department of dermatology. Such a presentation illustrates the ways in which patients whose psychological issues and skin disease are interrelated can be more comprehensively and effectively treated by an integrated psychodermatological approach.

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