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[Dermatitis artefacta]

M D Reis1, A Barbosa, J Matildes

  • 1Clínica Dermatológica Universitária, Hospital de Santa Maria, Lisboa.

Acta Medica Portuguesa
|April 2, 1998
PubMed
Summary
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A man with self-inflicted skin lesions on his jaw was diagnosed with dermatitis artefacta. This diagnosis considered lesion appearance, personality, found objects, and patient admission of lesion aggravation.

Area of Science:

  • Dermatology
  • Psychiatry

Background:

  • Dermatitis artefacta is a rare factitious disorder where individuals intentionally cause self-inflicted skin lesions.
  • Understanding the psychological underpinnings is crucial for accurate diagnosis and management.

Observation:

  • A 29-year-old male presented with bilateral ulcerative lesions on the mandible.
  • The lesions' morphology and progression were atypical for common dermatological conditions.
  • Objects potentially used to inflict harm were found in the patient's possession.

Findings:

  • The clinical presentation, patient's borderline personality traits, and discovered objects supported a diagnosis of dermatitis artefacta.
  • The patient later admitted to actively participating in the worsening of his own lesions.

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Implications:

  • This case highlights the importance of considering factitious disorders in unexplained dermatological presentations.
  • Integrated psychiatric and dermatological care is essential for managing patients with dermatitis artefacta.
  • Early recognition can prevent unnecessary treatments and improve patient outcomes.