Dermatitis Artefacta: An Update

Dermatitis artefacta is a specific psychocutaneous illness, in which the patient creates skin lesions to satisfy the unconscious need to presume a sick role. It is more common in women and in patients with a diagnosis of psychiatric illness/personality disorder (usually borderline) or external stressor. The clinical signs are characteristic and usually present with typical psychiatric manifestations. This diagnosis is by exclusion, and possible organic causes of cutaneous lesions must be ruled out. Treatment of dermatitis artefacta is taxing, both on the physician as well as on relatives, and it needs to involve a multidisciplinary approach consisting of dermatologists and mental health professionals.