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Identifying and managing naevus dysmorphia in clinical practice

Affleck, Andrew G; Wray, Emma; Chouliara, Zo�

Authors

Andrew G Affleck

Emma Wray

Zo� Chouliara



Abstract

Naevus dysmorphia is a form of appearance concern/body image dissatisfaction, which describes a preoccupation with the appearance of a clinically small melanocytic naevus. The naevus is perceived by the patient to be disfiguring. Such perception leads to maladaptive behaviours and is often associated with low mood, as well as high levels of anxiety and social avoidance. Affected individuals form a diverse group. However, what they have in common is that the distress experienced is disproportionate to the objective visual appearance of the mole. There is a range of severity of the impact on the individual’s well being. Naevus dysmorphia may or may not be a cutaneous manifestation of body dysmorphic disorder (BDD). It is essential that patients with naevus dysmorphia are identified and distinguished from patients requesting removal of a mole for other uncomplicated cosmetic reason. Patients with naevus dysmorphia can be challenging to treat and communicate with. Surgical excision of the naevus will not address the underlying psychopathology and so it may not result in long-term positive outcome. Ideally, a detailed psychological assessment and formulation can be made potentially followed by psychological therapy tailored to the needs of the individual. A therapeutic trial of appropriate psychopharmacological course may be indicated in certain cases, e.g., when symptoms of a depressive disorder, anxiety disorder or BDD are present. A case series of 10 patients with naevus dysmorphia is presented, in order to highlight the above issues.

Journal Article Type Article
Acceptance Date Apr 1, 2015
Online Publication Date Apr 7, 2015
Publication Date May 2, 2015
Deposit Date Apr 27, 2015
Print ISSN 2218-6190
Peer Reviewed Peer Reviewed
Volume 4
Issue 2
Pages 114
DOI https://doi.org/10.5314/wjd.v4.i2.114
Keywords Naevus dysmorphia; Body dysmorphic disorder; Body image dissatisfaction; Psychological distress
Public URL http://researchrepository.napier.ac.uk/id/eprint/7860
Publisher URL http://dx.doi.org/10.5314/wjd.v4.i2.114