Journal of the American Academy of Dermatology
Volume 63, Issue 2 , Pages 235-243 , August 2010

Body dysmorphic disorder among dermatologic patients: Prevalence and clinical features

  • Luciana Archetti Conrado, MD, PhD

      Affiliations

    • Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
    • Corresponding Author InformationReprint requests: Luciana Archetti Conrado, MD, PhD, Clinica de Dermatologia Luciana Conrado, Rua Caconde, 96/104. CEP: 01425-010. São Paulo/SP Brazil.
  • ,
  • Ana Gabriela Hounie, MD, PhD

      Affiliations

    • Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
  • ,
  • Juliana Belo Diniz, MD, PhD

      Affiliations

    • Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
  • ,
  • Victor Fossaluza, MS

      Affiliations

    • Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
  • ,
  • Albina Rodrigues Torres, MD, PhD

      Affiliations

    • Department of Neurology, Psychology, and Psychiatry of Botucatu Medical School–São Paulo State, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), São Paulo, Brazil
  • ,
  • Euripedes Constantino Miguel, MD, PhD

      Affiliations

    • Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
  • ,
  • Evandro Ararigboia Rivitti, MD, PhD

      Affiliations

    • Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil

,Accepted 18 September 2009.

References 

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 Funding sources: None.

 Conflicts of interest: None declared.

PII: S0190-9622(09)01210-9

doi: 10.1016/j.jaad.2009.09.017

Journal of the American Academy of Dermatology
Volume 63, Issue 2 , Pages 235-243 , August 2010