Psychodermatology Tools in Context: Structured Screening, Bias, and Maintaining Therapeutic Alliance

Structured screening tools such as the Factitious Skin Disorder Inventory offer a promising approach to recognising complex psychodermatological presentations within dermatology clinics. However, screening tools often risk oversimplifying diagnostically heterogeneous conditions, introducing cognitive bias, and potentially undermining therapeutic relationships if applied without sufficient clinical context. We highlight the need for cautious integration, emphasising the importance of holistic assessment, diagnostic vigilance, and strengthened psychodermatology training to ensure such tools support rather than replace clinical judgement.