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Self-inflicted pathological cutaneous disorders. Part II.

Domenico Bonamonte1, Caterina Foti2, Aurora DE Marco2

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Self-inflicted skin disorders, comprising factitious and compulsive types, represent 2% of dermatology visits. Management requires integrated psychiatric and dermatological assessment.

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Area of Science:

  • Dermatology
  • Psychiatry

Background:

  • Self-inflicted skin disorders are artefact diseases accounting for 2% of dermatology patient visits.
  • These disorders are categorized into factitious disorders (denied pathological behavior) and compulsive disorders (non-denied pathological behavior).
  • Factitious disorders are further divided into those without external incentives and those with external incentives.

Purpose of the Study:

  • To discuss self-inflicted skin disorders with external incentives, including malingering and pathomimic artefacts.
  • To explore behavioral disorders involving compulsive habits leading to self-inflicted dermatoses.
  • To outline the management strategies for self-inflicted cutaneous diseases.

Main Methods:

  • Review of literature on self-inflicted skin disorders.
  • Classification of factitious and compulsive skin disorders.
  • Discussion of diagnostic and management approaches.

Main Results:

  • Factitious disorders with external incentives involve simulation for illicit intent, such as evading duties or occupational exploitation.
  • Compulsive disorders, like tics and psychological excoriations, are often confessed by patients.
  • Effective management necessitates a combined psychiatric and dermatological assessment.

Conclusions:

  • Self-inflicted skin disorders encompass a range of conditions with diverse motivations and presentations.
  • Distinguishing between factitious and compulsive self-inflicted dermatoses is crucial for appropriate management.
  • Integrated care involving both psychiatric and dermatological expertise is essential for optimal patient outcomes.