Dermatitis artefacta
{{Infobox medical condition (new)
| name = Dermatitis artefacta
| synonyms = Factitious dermatitis
| image = Factitious dermatitis.jpg
| caption = Factitious dermatitis
| alt = Multiple, well-demarcated, linear, longitudinal erosions on the dorsum of the bilateral forearms
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Dermatitis artefacta, also known as Factitious dermatitis, is a form of factitious disorder in which patients will intentionally feign symptoms and produce signs of disease in an attempt to assume the patient role. It is also self-inflicted skin damage, most commonly from prolonged deliberate scratching, but sometimes by means of sharp instruments or another agency.Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. {{ISBN|0-07-138076-0}}.{{rp|391}}{{cite book |author1=James, William D. |author2=Berger, Timothy G. |title=Andrews' Diseases of the Skin: clinical Dermatology |publisher=Saunders Elsevier |year=2006 |isbn=978-0-7216-2921-6 |display-authors=etal}}{{rp|61}}
Signs and symptoms
The cutaneous lesions that are commonly seen are unusual, resembling numerous recognized inflammatory responses in the skin.{{cite journal | last=Verraes-Derancourt | first=S. | last2=Derancourt | first2=C. | last3=Poot | first3=F. | last4=Heenen | first4=M. | last5=Bernard | first5=P. | title=Pathomimie : étude rétrospective de 31 malades | journal=Annales de Dermatologie et de Vénéréologie | publisher=Elsevier BV | volume=133 | issue=3 | year=2006 | issn=0151-9638 | doi=10.1016/s0151-9638(06)70886-9 | pages=235–238 | language=fr}} When a false history is given, it is typically "hollow," with no explanation of how specific skin lesions that develop on easily accessible areas suddenly become fully formed.{{cite web | last=Chandran | first=Veena | last2=Kurien | first2=George | title=Dermatitis Artefacta | publisher=StatPearls Publishing | date=2022-07-12 | pmid=28613686 |url=https://www.ncbi.nlm.nih.gov/books/NBK430936/ | access-date=2024-03-10}}
Causes
Inducing lesions is a psychological strategy used by the patient to satiate an internal need, most commonly the desire for attention or care. Several psychosocial difficulties, emotional immaturity, unconscious motives, and dysfunctional interpersonal relationships have all been identified as etiological factors.{{cite journal | last=Mohandas | first=Padma | last2=Ravenscroft | first2=Jane C. | last3=Bewley | first3=Anthony | title=Dermatitis artefacta in childhood and adolescence: a spectrum of disease | journal=Italian Journal of Dermatology and Venereology | publisher=Edizioni Minerva Medica | volume=153 | issue=4 | year=2018 | issn=2784-8671 | doi=10.23736/s0392-0488.18.06019-4 | page=}}{{cite journal | last=Krooks | first=J. A. | last2=Weatherall | first2=A. G. | last3=Holland | first3=P. J. | title=Review of epidemiology, clinical presentation, diagnosis, and treatment of common primary psychiatric causes of cutaneous disease | journal=Journal of Dermatological Treatment | publisher=Informa UK Limited | volume=29 | issue=4 | date=2017-11-05 | issn=0954-6634 | doi=10.1080/09546634.2017.1395389 | pages=418–427}}
Treatment
Topical antibiotics may be necessary to treat the skin lesions, but if a serious infection is present, oral antibiotics may also be necessary in certain situations. It is necessary to identify and treat the underlying mental health condition. Medications used frequently include sedatives, antipsychotics, and antidepressants.
See also
References
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Further reading
- {{cite journal | last=Saha | first=Abhijit | last2=Seth | first2=Joly | last3=Gorai | first3=Surajit | last4=Bindal | first4=Ayush | title=Dermatitis artefacta: A review of five cases: A diagnostic and therapeutic challenge | journal=Indian Journal of Dermatology | publisher=Medknow | volume=60 | issue=6 | year=2015 | issn=0019-5154 | doi=10.4103/0019-5154.169139 | doi-access=free | page=613 | ref=none| pmc=4681205 }}
- {{cite journal | last=Tittelbach | first=Jörg | last2=Peckruhn | first2=Melanie | last3=Elsner | first3=Peter | title=Histopathological patterns in dermatitis artefacta | journal=JDDG: Journal der Deutschen Dermatologischen Gesellschaft | publisher=Wiley | volume=16 | issue=5 | date=2018-04-24 | issn=1610-0379 | doi=10.1111/ddg.13504 | pages=559–564 | ref=none}}
External links
- [https://dermnetnz.org/topics/dermatitis-artefacta DermNet]
- [https://www.visualdx.com/visualdx/diagnosis/factitial+dermatitis?diagnosisId=51393&moduleId=101 VisualDx]
{{Medical resources
| ICD11 = {{ICD11|ED00}}
| ICD10 = {{ICD10|L|98|1|l|80}} (ILDS L98.100)
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| ICD9 = {{ICD9|698.4}}
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| DiseasesDB = 29765
| SNOMED CT = 402737007
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| eMedicineSubj = article
| eMedicineTopic = 1121933
| PatientUK =dermatitis-artefacta
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{{Factitial dermatitis}}