Rash has been described in several outbreaks of psychogenic illness. In such situations, rash often may be associated with pruritus and may occur on exposed skin in a distribution that suggests scratching as a cause. Outbreaks of mass psychogenic illness often involve acute onset and rapid spread of symptoms, with minimal physical or laboratory findings. Reported outbreaks affect females disproportionately more often than males, and frequently involve adolescents or children. The latter term refers to the apparent spread of symptoms among persons who see others become ill.
Symptoms can recur in the setting of the initial outbreak.
7 Media coverage frequently escalates such outbreaks. 7,18-20 Epidemiologic characteristics frequently associated with mass psychogenic illness are summarized in Table 2. Unfortunately, there is no single definitive diagnostic trait of mass psychogenic illness. Exceptions to each of the typical characteristics have been reported. Potential litigation or monetary compensation for mass psychogenic illness can complicate outbreaks 2,19 and may make it difficult to differentiate between illness and malingering.