[My fingers itch, but my hands are bound. An exploratory psychosomatic study of patients with dyshidrosis of the hands (cheiropompholyx)].

The purpose of a pilot study with 20 patients, suffering from dyshidrotic exzema of the hands, was to investigate the relevance of a psychosomatic approach for its etiology and therapy. A set of psychological and allergological tests revealed the following results. - 10 patients suffered from a contact allergy (epicutaneous test), 6 of them were allergic to nickel - the patients were less aggressive and more permissive (Freiburger Personality Inventory; FPI) as compared to a standard population. They reported more somatic complaints (HHM) as healthy subjects. - the results of a semistructured interview support the hypothesis, that the dyshidrotic exzema often has an expressive function: the patients present their dependency conflict in a symbolic manner by means of their hands. They try to take their life in their own hands; autonomous actions however are hampered by their own dependency needs. The development of the dyshidrotic symptoms corresponds to the autonomy, which has been achieved with regard to the individual conflict of ambivalence. According to our findings the contact with nickel is not predominant, neither causative nor triggering, factor. Following the psychosomatic concept of Engel and Schmale, the authors discuss the pathogenesis of dyshidrosis with the meaning of a complication of (pregenital) conversion, with the hands as the part affected.