Factitious Disorder as a Skin Ulcer: A Case Report

Area of Science:

• Dermatology and Psychiatry
• Psychosomatic Medicine

Background:

• Dermatitis artefacta (factitious dermatitis) is a self-induced skin condition presenting diverse clinical manifestations.
• This disorder is often associated with significant psychological distress, including anxiety and potential self-harm behaviors.
• Factitious disorder involves the deliberate creation of physical symptoms to fulfill a psychological need for attention within a medical setting.

Observation:

• A case report of a 17-year-old female patient presenting with a factitious disorder manifesting as a skin ulcer on her right ankle.
• The patient experienced severe anxiety symptoms, including insomnia and difficulty concentrating, related to academic pressures.
• She refused mental health evaluation despite the onset of anxiety symptoms over the preceding four months.

Findings:

• The patient's skin ulcer was diagnosed as a factitious disorder, a condition where individuals feign illness.
• The underlying cause is psychological, driven by a need for attention and care within the healthcare environment.
• Symptoms lack significant physiological benefit and are primarily psychological in origin.

Implications:

• Psychotherapy is the primary treatment modality for factitious disorder.
• Dermatosurgical intervention is necessary for managing the physical manifestations, such as skin ulcers.
• Early identification and integrated treatment approaches involving dermatology and mental health professionals are crucial for managing factitious dermatitis.