Obsessive-compulsive disorders in the pediatric dermatology practice.

Childhood and adolescent obsessive-compulsive disorders are sometimes seen in dermatology practice. When present, OCD is most frequently manifested in younger patients as trichotillomania, onychotillomania, onychophagia, and acne excoriée. In addition to these disorders, obsessive hand washing, AIDS phobia, and other psychosomatic dermatoses characterized by obsessive-compulsive tendencies are seen in all age groups. It is important to define the nature of any underlying psychiatric disorder before beginning drug treatment of these patients. With the availability of new medications, most notably, clomipramine and fluoxetine, there is reason for optimism regarding the treatment of OCD. Whenever feasible, the dermatologist should not hesitate to involve a psychiatrist to help with diagnosis and treatment when the diagnosis of OCD is being considered.