[Tattooing and self-mutilation of the skin in neurotic character disorder]

Self-tattooing is a form of self-mutilation and may sometimes come close to an 'artefact'. Self-tattooing as an action of autoaggressive self-mutilation or self-destruction is not always necessarily psychotic in nature; it may also be found in patients in whom a depressive personality structure is accompanied by strong masochistic tendencies at a neurotic level. The masochistic excess expresses subconscious guilt and aggression as well as a primitive sense of autonomy. Close collaboration between dermatologist, psychiatrist and psychotherapist is necessary to provide an effective treatment for these patients.