In pediatric OCD, around 40% still have the disorder in adulthood, and around 40% qualify for remission. History
Plutarch, an ancient Greek philosopher and historian, describes an ancient Roman man who possibly had scrupulosity, which could be a symptom of OCD or OCPD. This man is described as "turning pale under his crown of flowers," praying with a "faltering voice," and scattering "incense with trembling hands. "In the 7th century AD, John Climacus records an instance of a young monk plagued by constant and overwhelming "temptations to blasphemy" consulting an older monk, who told him: "My son, I take upon myself all the sins which these temptations have led you, or may lead you, to commit. All I require of you is that for the future you pay no attention to them whatsoever. ": 212  The Cloud of Unknowing, a Christian mystical text from the late 14th century, recommends dealing with recurring obsessions by attempting to ignore them, and, if that fails, to "cower under them like a poor wretch and a coward overcome in battle, and reckon it to be a waste of your time for you to strive any longer against them", a technique now known as emotional flooding. : 213 From the 14th to the 16th century in Europe, it was believed that people who experienced blasphemous, sexual or other obsessive thoughts were possessed by the devil. : 213  Based on this reasoning, treatment involved banishing the "evil" from the "possessed" person through exorcism.
Drug induced pigmentation may take on many different appearances, one of the most common being a change in the color, or pigmentation, of the skin. Presentation
Cause
Drug-induced pigmentation of the skin may occur as a consequence of drug administration, and the mechanism may be postinflammatory hyperpigmentation in some cases, but frequently is related to actual deposition of the offending drug in the skin. : 125–6 The incidence of this change varies, and depends on the type of medication involved. Some of the most common drugs involved are NSAIDs, antimalarials, psychotropic drugs, Amiodarone, cytotoxic drugs, tetracyclines, and heavy metals such as silver and gold (which must be ingested, not just worn). Pathophysiology
There are 4 possible mechanisms to how this change may occur:
Accumulation of melanin, the skin pigment
Accumulation of drug or one of its products under any layer of the skin (usually the dermis or epidermis)
Accumulation of iron throughout the dermis from drug-induced post-inflammatory changes
The synthesis of special pigments, under direct influence of the drug

See also
Skin lesion

References


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