Medically Unexplained Dermatologic Symptoms (MUDS): Hiding in plain sight?

By David J. Elpern, M.D. J Eur Acad Dermatol Venereol. 2018 Jul;32(7):e265-e266 Keywords: medically unexplained symptoms, somatoform disorders, symptoms, illness, disease Illness is not the same as disease. Illness refers to “the innately human experience of symptoms and suffering.”1 Disease “is what the practitioner creates in recasting illness in terms of theories of disorder.” A person’s subjective experience of how she feels may not assume an underlying pathology. Illness can be organic, psychological or spiritual. A person can feel ill, but not have a disease. Consider Sara (not her real name), a 31-year-old social worker who sought dermatological care for a seven-year history of painful vulvodynia and generalized pruritus. Her … Continue reading

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MUDS: In Search of Medically Unexplained Dermatological Symptoms

by David J. Elpern, M.D. Medically unexplained symptoms (MUS) are relatively well-known in the literature but not discussed in any dermatology journal. A recent book, Is It All In Your Head?: True Stories of Imaginary Illness, by by the neurologist Suzanne O”Sullivan is a readable and accessible resource. While studied in primary care, neurology and rheumatology, our PubMed review found no mention of medically unexplained symptoms in a major dermatology journal. Yet two surveys conducted in my office, each of of 100 consecutive dermatology clinic patients, found that ~ 20% had some form of MUDS. This rate is congruent with the estimated prevalence of MUS.  It appears that MUDS are … Continue reading

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