Idiopathic environmental intolerances: Psychosomatic and somatic aspects

Multiple chemical sensitivity (MCS) or idiopathic environmental intolerances (IEI) (also called 'eco-syndrome') describes a syndrome of somatic and/or psychosomatic complaints of mostly subjective nature, attributed to environmental noxious agents. We report the case of a 58-year-old woman with a long-lasting history of hypersensitivity phenomena and manifold symptoms which she believed to be provoked by environmental influences. Thorough and interdisciplinary diagnostics including extensive allergological testing procedures (provocative tests) revealed both somatic diagnoses (contact allergy, pseudo-allergic reactions, sicca syndrome, liver steatosis, porokeratosis superficialis disseminata actinica) as well as psychiatric diagnoses (predisposition to depression). Some symptoms improved in the course of the disease. The basis for successful 'management' of these patients is co-operation between allergists, specialists in the relevant field, and psychiatrists or psychologists.