2009 Volume 8 Issue Suppl.12 Pages B707-B712
A case of atopic dermatitis complicated with Asperger’s disorder and learning disorder was reported and our effort and measure are described to manage this complex disorder. The patient is a 13-year-old boy who has a severe atopic dermatitis since infant. At the age of 9, he was diagnosed having Asperger’s disorder and learning disorder by child psychiatrist. He also had elaborate family problems, his parents’ divorce and his mother’s suffering from depression and panic disorder. His skin care has not been enough because of his unstable temper and poor familial support. In addition panic with acting out happened and increased its frequency of attack. When his desire was not gratified, he lost control of himself to act violence, to break surrounding goods, and to injure himself. Child psychiatrist was consulted for relieving and managing his behavior disorder. His weekly visit to her for psychiatric treatment including psychotropic drugs started. The strategy based on behavior therapy was established by meeting of our team consisting of dermatologist, nurse and school teacher to manage his disorder and to achieve good control of his skin lesion. The essentials of the strategy were listening to him supporting his narrative story, giving compliment to his effort or improvement, guiding his improper behavior by pointing out just simply, using concrete words avoiding vague expression.For his panic action we ignored his behavior observing until getting to be calm down and took care the surroundings not to be injured. As concerns of eczema treatment, explaining topical application as easy as possible by using colored figure, and keeping his treatment motivation by having him come repeatedly to us. As a result, his panic action gradually decreased in frequency as his mental status got stability and his skin lesion was getting improved. Attainment of mental stability by management considering his disorder played a great role for improving not only his daily life but also his dermatitis.
