Antidepressant-induced Remission of Gardner Diamond Syndrome
A 25-year-old young, married woman was referred to the psychiatry outpatient department by the dermatologist. A detailed evaluation revealed that the patient was having depressive symptoms since a year. Her predominant symptoms included sadness of mood, helplessness, hopelessness, feeling of lethargy, and inability to do her routine household work. This created interpersonal problems with her in-laws who considered her to be slow in her work and would repeatedly taunt her. The patient was married young and she still had difficulty in adjusting in her in-laws' home. She had also lost her mother at a young age and was unable to share her marital problems with any of her relatives including her siblings. The ongoing continuous interpersonal stressors had now affected her sleep and appetite, and since a year, she had also become very irritable. She was extremely worried about her future and felt that her situation was hopeless. It was during one of her visits to her dermatologist that she voiced her grievances due to which she was referred to psychiatry.\nThe detailed psychiatry evaluation revealed the patient to be suffering from a mild depressive disorder without somatic symptoms as per the ICD10 criteria.[] She had recently developed symptoms of bruising associated with pain over arms and face, occurring recurrently after a fall from the stairs for which she was under treatment from the dermatologist and was diagnosed as having Gardner Diamond syndrome. These symptoms of bruising and associated pain would occur nearly on a daily basis on either her arms, forearms, or predominantly over her cheeks []. They would resolve over a week and new lesions would crop up. As per the dermatologist, there was no known treatment for this syndrome, and the patient was prescribed analgesics for the symptoms of pain. In view of her depressive symptoms, the patient was started on antidepressant Tab. escitalopram 5 mg at night, which was gradually increased to 10 mg over the next fortnight. What was surprising was that as her depression improved and the patient started feeling better, her symptoms of recurrent bruising and pain completely subsided and in her follow-up of 2 months, the patient is currently symptom free, maintained on the antidepressant.