HARCP Archives

Browse by article

Browse by volume

Heroin Addiction and Related Clinical Problems: 2020, 22, N4 (pages: 5 - 14)

Dermatological and Psychiatric Manifestations in Heroin and Bonsai Use Disorder

Can Y., Kıvanç Altunay İ., Mercan S., Evren C., Poşpoş Ö.H., and Özkur E.

Summary: Background: In in cases of substance use disorder (SUD), dermatological findings may provide significant information about the mental state of the patients involved. Awareness of cutaneous signs together with psychiatric manifestations may be an effective way to address the issue of treating substance use. Aims: This study aims to detect cutaneous signs and mental state of patients with heroin and bonsai use disorder through dermatological and psychiatric examinations. Methods: 156 male inpatients with SUD (heroin, n=104 and bonsai, n=52) were included. A standart personal information form, the Symptom Checklist-90-Revised (SCL- 90-R) and the Drug Use Disorders Identification Test (DUDIT) were filled out by each patient. Assessment of patients' psychiatric condition and their dermatological examinations were performed by the same psychiatrists and the same dermatoalogist. Tattoos and self-inflicted scars (SIS), which were the result of self-harm behavior (SHB) were rated separately. Results: The most frequent and dramatic findings in all SUD cases were tattoos (n=70), SIS (n=64), traumatic scars (n=59), cutaneous infections (n=49), acne (n=42), and vascular lesions (n=18). Injection scars, and vascular lesions were detected at higher rates in heroin users, while acne lesions were significantly more frequent in bonsai users (p =0.022). The rates recorderd for having tattoos were 32.7% (n=17) in bonsai users and 51% (n=53) in heroin users. The age of onset for first substance use, and regular substance use, besides the patients' age at first treatment were both lower in tattoo patients than in those without tattoos. From subscale scores of SCL 90-R, the somatization, depression, interpersonal sensitivity, anxiety scores were all higher in heroin users than in bonsai users. Conclusions: Physicians should be aware of dermatological clues in SUD patients. Evaluation of dermatological findings including tattoos is important in detecting SUD and obtaining information on the mental state of the patients.