[Self-induced dermatosis on the shoulder].

Area of Science:

• Psychiatry
• Dermatology
• Toxicology

Background:

• Self-induced dermatoses are rising among adolescents with substance abuse and adjustment difficulties.
• Adolescent substance abuse is often linked to underlying psychological distress and behavioral issues.

Observation:

• A 22-year-old male presented with bullous lesions on his left shoulder.
• The lesions, characterized by blisters, erosions, and scabs, were self-inflicted via cigarette burns.
• The patient had a history of substance abuse (cannabis, alcohol), major depression, suicidal ideations, and conflict with his parents.

Findings:

• The presentation suggested factitious disorder or self-induced dermatosis due to lesion accessibility and psychiatric history.
• Psychological evaluation confirmed suicidal ideations and aggressive behaviors.
• Cigarette burns were identified as the cause of the bullous eruption.

Implications:

• This case underscores the importance of considering self-induced dermatoses in adolescents presenting with unusual skin lesions and psychiatric comorbidities.
• Early psychiatric intervention is crucial for managing self-harm behaviors and improving patient outcomes.
• Integrated care addressing both dermatological and psychological needs is essential for this patient population.