[Dermatitis artefacta (factitial dermatitis)--an interdisciplinary diagnostic and therapeutic challenge]

Area of Science:

• Dermatology
• Psychiatry
• Psychosomatic Medicine

Background:

• Factitial cutaneous lesions stem from self-inflicted injuries, causing significant skin damage.
• These lesions are often associated with underlying psychiatric disorders or stressful life events.
• Clinical presentations vary widely, from minor erosions to severe wounds.

Purpose of the Study:

• To highlight the diagnostic challenges associated with factitial cutaneous lesions.
• To emphasize the importance of considering self-inflicted injury in differential diagnoses.
• To advocate for early interdisciplinary cooperation in managing these complex cases.

Main Methods:

• Review of clinical manifestations of factitial cutaneous lesions.
• Analysis of diagnostic difficulties and patient/therapist acceptance.
• Discussion of therapeutic implications and the need for a multidisciplinary approach.

Main Results:

• Diagnosis of factitial lesions is frequently delayed and complex.
• Patient and therapist acceptance of the underlying self-inflicted pathology can be a significant barrier.
• Effective management requires integrating dermatological and psychiatric expertise.

Conclusions:

• Factitial cutaneous lesions necessitate inclusion in differential diagnostic considerations for unexplained skin damage.
• Early and consistent interdisciplinary collaboration is essential for successful therapeutic outcomes.
• Addressing the psychological triggers is paramount for long-term management of self-inflicted skin injuries.