[Cutaneous artefacts--possibilities for treatment and their limits]

Factitious disorders (FD) of the skin are emergency calls of the patient, whose psychological problems are mostly unconscious. The therapeutic approach is difficult, because the patient does not accept the necessary psychiatric or psychotherapeutic therapy. Therefore, they remain under the medical care of their dermatologists. We report on the experiences of our psychological team gathered during a clinical study on 16 patients with FD. We distinguish between three types of FD, each implicating a different therapeutic approach: unconscious FD (type A), conscious FD (type B), and so-called neurotic excoriations (type C). On the basis of 3 corresponding cases, we discuss the possible psychosomatic therapeutic approaches, the indications and limits of the treatment, as well as prognostic aspects.