"I always do a mental health screen on each and every patient, even if they have mild AD, because I want to catch these patients early."

A patient suicide is not something a dermatologist is trained to expect. For Mona Shahriari, MD, assistant clinical professor of dermatology at the Yale School of Medicine, the experience in her own practice changed the way she thinks about mental health in the context of atopic dermatitis (AD). Shahriari spoke with Patient Care at Revolutionizing Atopic Dermatitis (RAD) in Nashville, TN, following her presentation titled "The Psychosocial Burden of AD," where she explored the cumulative emotional burden of the disease over time.

Dermatologic conditions, because they are visible, expose patients to external reaction, whether real or perceived, and the mental health burden may become extreme over time, Shahriari pointed out. On the other hand, because the conditions are visible, seeing the progress as they improve can be reinforcing and reassuring. In the case of her patient, however, she had tried the full range of treatments, topicals, orals, injectables, "but she was bullied, and the way her skin felt and looked was unbearable to her. Her mother told me that despite all we had offered, she had simply had enough."

In the video above Shahriari highlights the enduring lesson this single patient taught her about never underestimating the internal impact such an external disease can have.

Mona Shahriari, MD is assistant clinical professor of dermatology at Yale University School of Medicine in New Haven, CT and co-founder of Central Connecticut Dermatology in Cromwell, CT

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