Psychiatric comorbidities commonly accompany dermatological lesions and may aggravate their clinical course via stress-mediated pathways. Identification and treatment of concomitant psychiatric disorders in these patients may facilitate improvement in both psychiatric symptomatology and dermatological manifestations.

A 51-year-old female patient with treatment-refractory chronic urticaria, comorbid depression, and anxiety presented to the psychiatry outpatient clinic. The patient reported in her medical history that the eruptions were triggered by stress and denied any other precipitating factors. The Beck Anxiety Inventory (BAI) and the Patient Health Questionnaire-9 (PHQ-9) were administered before and after treatment. A detailed medical history was obtained, physical examination findings were recorded, and dermatological lesions were compared pre- and post-treatment. Following one month of escitalopram therapy, a significant regression of the lesions was observed, accompanied by improvement in psychiatric symptoms, as reflected by decreased BAI and PHQ-9 scores.

Although the precise pathophysiological mechanisms have not yet been fully elucidated, the clinical improvement observed following escitalopram therapy may be attributable to stress reduction. Therefore, the aim of this case report is to investigate the presence of psychiatric comorbidities accompanying dermatological lesions, to discuss potential treatment strategies for these comorbidities, and to evaluate their possible impact on the clinical course. Additionally, through this case, the importance of a comprehensive and psychosocial approach to patient care, as well as the role of family physicians, will be addressed.

Keywords: Urticaria, anxiety, depression, escitalopram, emotional stress