When considering the impact of skin disease, many people fail to realise just how important the psychological aspects can be. Skin disease is often considered to be 'only cosmetic' by many medical professionals and lay-people alike, but unlike most internal illnesses, skin disease is often immediately visible to others. It is for this reason that traditional views do not account for the often profound psychological impact that it can exert on those affected. Skin disease can affect the quality of life, self-esteem and body image, as well as the way patients live their day-to-day lives. Furthermore, the way that skin disease affects a person often has no relation to traditional conceptualisations of medical severity. To truly understand the effect, we need to understand the person behind the condition. Through the course of our work we have encountered individuals whose skin disease covers the majority of the surface of their skin but whose social and psychological functioning were unaffected by the condition. Conversely, individuals with the smallest of lesions in non-visible areas have been so affected by their condition that occupational, social and sexual interactions have fallen prey to their functional inability to cope with their condition. The unique nature of skin disease has the potential to make it both the easiest or most difficult disease to suffer and how a person copes and adapts to the challenges presented is due to a great number of factors. Recent years have seen a considerable increase in research concerned with the psychological effects of skin disease on patients and their families, and we are beginning to appreciate the degree to which a variety of problems confront both patients and their wider social networks.

The question of what exactly is psychodermatology is one that should be addressed at the start of this text so that we understand the direction with which we, as health professionals, approach the topic. Psychodermatology is as much an ethos as a discipline; a professional, clinical and research-orientated awareness, and acceptance of the psychological and social implications of dermatological conditions and this text is an important contribution to the field of psychodermatology, not only because of its content but because of the readership that we hope to target. This book was designed to give us a better understanding of the ways in which health professionals can be maximally effective in addressing the different elements that matter to skin disease sufferers of all ages. As such, it has been written for a broad range of readers comprising not only researchers who work in the area of skin disease but the range of professionals who come into contact with skin disease patients and their families, including dermatologists, dermatology nurses, psychologists, psychiatrists and general practitioners. The chapters in this volume offer a guided tour through the key areas of the subject, discussing in detail the biological, psychological and social implications of dermatology, and we would like to think that this provides professionals with a reference framework for the different factors involved in living with skin disease.

We feel that there should be a greater collaboration between clinicians and researchers in order to improve both the quality of research and the quality of clinical care that patients receive, and this volume highlights just why this is so crucial.

Above all, we hope that this text will stimulate professionals working in the field of dermatology to explore their supportive communication and increase awareness regarding the difficulties that patients with skin disease can face. One of the great problems facing those with skin disease is the trivialisation and minimisation of the associated difficulties and distress and if, with this book, we are able to highlight the struggle that some people affected by dermatology endure then it will have been a worthwhile endeavour.

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