History and Examination

This chapter describes the approach to carrying out an initial and follow-up assessment of patients with psychocutaneous disease, and is written from the perspective of both a dermatologist and psychiatrist. Different models of joint working between psychiatry and dermatology are outlined. Practical details of the assessment setting, confidentiality, and notekeeping/correspondence are discussed. The general approach to engaging the patient and details of assessing and investigating the skin disorder are explained. Recommendations are made about the use of standardized psychiatric assessment questionnaires and appropriate laboratory investigation. Specific challenges posed in engaging some of these patients in psychiatric assessment are outlined, together with some potential strategies.