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Dermatitis Artefacta: A Study of 42 Patients With Management Considerations.

Paula Gerlero1, Nycolle L K O Guedes1, Alexandre J Dwan1

  • 1Department of Dermatology, Medical School, University of São Paulo, São Paulo, Brazil.

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Summary

Dermatitis artefacta (DA) is a self-inflicted skin condition. This study found that dermatologist-led care, potentially with placebo pills, improves patient outcomes and adherence, making psychiatric referral less critical.

Keywords:
dermatitis artefactafactitial dermatitispsychodermatology

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Area of Science:

  • Psychodermatology
  • Psychiatric Dermatology
  • Behavioral Dermatology

Background:

  • Dermatitis artefacta (DA) is a psychiatric disorder characterized by self-inflicted skin lesions.
  • Patients with DA often exhibit complex behaviors, including attention-seeking and emotional release.
  • Research on DA is challenging due to patient mobility and limited follow-up data on treatment efficacy.

Purpose of the Study:

  • To investigate the clinical characteristics of patients diagnosed with dermatitis artefacta.
  • To evaluate the therapeutic outcomes for patients with DA undergoing treatment at a Brazilian university medical center.
  • To analyze the long-term follow-up data for patients with self-inflicted skin lesions.

Main Methods:

  • A retrospective study design was employed, analyzing medical records of patients with DA.
  • Data collected included personal information and treatment details.
  • Patient follow-up periods varied, ranging from single visits to seven years.

Main Results:

  • Forty-two patients with dermatitis artefacta were included in the analysis.
  • Treatment modalities varied: 20 received placebo pills with topical treatments, 14 received no treatment, and 4 used only topical treatments.
  • Psychiatric evaluations were infrequently conducted in the absence of a dermatologist.

Conclusions:

  • Dermatologists are crucial in diagnosing and managing dermatitis artefacta.
  • Referrals to psychiatrists were often unsuccessful, highlighting the importance of dermatological management.
  • Placebo pills can enhance patient adherence and strengthen the doctor-patient therapeutic relationship in DA cases.