Dermatitis artefacta

A psychiatric condition characterized by self-inflicted skin lesions

Dermatitis artefacta is a psychodermatology condition where individuals deliberately create skin lesions on themselves. This behavior is often driven by underlying psychological issues, and the lesions are not caused by any organic skin disease. The condition is considered a form of factitious disorder, where the primary aim is to assume the sick role.

Clinical Presentation

Patients with dermatitis artefacta typically present with unusual skin lesions that do not conform to any known dermatological condition. These lesions can vary widely in appearance, depending on the method used to create them. Common methods include scratching, cutting, or applying caustic substances to the skin.

Factitious dermatitis

The lesions are often located in areas that are easily accessible to the patient, such as the face, arms, and legs. They may have sharp, geometric borders, which are atypical for naturally occurring skin conditions. The patient may provide a vague or inconsistent history regarding the onset and progression of the lesions.

Diagnosis

Diagnosing dermatitis artefacta can be challenging, as patients may be reluctant to admit to self-inflicting the lesions. A thorough clinical evaluation is necessary, often involving a multidisciplinary team including dermatologists and mental health professionals. Key diagnostic clues include:

• Lesions with bizarre shapes or patterns
• Inconsistent or implausible patient history
• Lesions that do not respond to standard dermatological treatments

Management

The management of dermatitis artefacta involves addressing both the skin lesions and the underlying psychological issues. Treatment strategies may include:

• Psychotherapy: Cognitive-behavioral therapy (CBT) can be effective in addressing the psychological factors contributing to the behavior.
• Dermatological care: Appropriate wound care and treatment of any secondary infections are essential.
• Multidisciplinary approach: Collaboration between dermatologists, psychiatrists, and psychologists is often necessary to provide comprehensive care.

Prognosis

The prognosis for dermatitis artefacta varies depending on the individual's psychological state and willingness to engage in treatment. With appropriate intervention, many patients can achieve significant improvement. However, the condition can be chronic and relapsing, particularly if underlying psychological issues are not adequately addressed.

Related Pages

• Factitious disorder
• Psychodermatology
• Self-harm