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


Darkness Visible: A Life of Chaos

a chaos of hard clay. Byron, Darkness Darkness Visible: A Life in Chaos It takes almost a decade to train a physician: at least seven years for a family practitioner and up to ten for cardiac- and neurosurgeons. We become technically proficient in treating diseases, but are not as adept at treating the illnesses that people present with. How often do we get, or make, the time to really get to know our patients? Physicians are comfortable with disorders that are clear-cut: diabetes, skin cancer, hypertension, and on and on. Yet, there is a subset of humanity with medically unexplained symptoms (MUS). Thirty to 50% of people seen by primary … Continue reading

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