[Munchausen syndrome. Artefacts in dermatology]

Cutaneous artefacts in the presence of Munchausen's syndrome can be clearly distinguished from simulation and hypochondria. In this paper we illustrate by means of two case reports the syndrome first described by Richard Asher in 1951. Patients with artefactual disease do not want to be cured, because the artefact may be the only possible way of reacting to and making contact with their surroundings. Because of their often dramatic history the relationship between physician and patient is emotionally charged from the very beginning, which is often very difficult for the attendant physician.