Factitial cutaneous ulcers and nodules: the use of electron-probe microanalysis in diagnosis

Two cases are reported in which persistent nodular or ulcerative skin lesions with granulomatous histology suggested possible injection of foreign material. Electron-probe microanalysis was used to determine the presence and nature of foreign materials present in the skin. This technic identified specific agents used as fillers in tablets, indicating the injection of pulverized tablet material. The patients were counseled regarding this evidence, and psychotherapy and drug rehabilitation were recommended in each instance. This technic provides a valuable tool for accurate identification of foreign substances in the skin.