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Dermatol Online J 2021 Mar 15;27(3). Epub 2021 Mar 15.

Department of Dermatology and Venereology, Centro Hospitalar São João, EPE Porto.

J Paediatr Child Health 2021 Feb 4. Epub 2021 Feb 4.

Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Psychiatr Danub 2020 09;32(Suppl 2):298-301

Department of Dermatology and Venereology, University Clinical Hospital Mostar, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.

Dermatol Ther 2020 11 7;33(6):e14235. Epub 2020 Sep 7.

NESMOS, Dermatology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.

Indian Dermatol Online J 2020 Jul-Aug;11(4):629-631. Epub 2020 Jul 13.

Department of DVL, IMS and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India.

Cureus 2020 Jul 7;12(7):e9054. Epub 2020 Jul 7.

Dermatology, University of Colorado School of Medicine, Aurora, USA.

Dermatitis artefacta is a rare psychological disorder in which patients self-inflict cutaneous lesions to satisfy an emotional need. Due to the nature of this disease, patients can present with a wide array of sometimes very severe skin lesions. Here, we describe a case of dermatitis artefacta initially misdiagnosed as pyoderma gangrenosum and treated as such for eight years. Read More

Dermatol Ther 2020 11 4;33(6):e14139. Epub 2020 Sep 4.

Dermatology, Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.

Clin Ter 2020 Jul-Aug;171(4):e288-e290

Dermatology Department, Sapienza University of Rome, Sant'Andrea General Hospital, Rome.

Dermatitis artefacta is a psychosomatic disorder characterized by cutaneous lesions that are self-inflicted by the patient, apparently due to itchy sensation. Usually, the patient denies any direct involvement with this condition and is rarely conscious of the underlying psychosomatic etiology. Authors report a case of a flight assistant with hypertrophic scars, symmetrically located on both upper arms. Read More

Lupus 2020 Sep 26;29(10):1282-1286. Epub 2020 Jun 26.

Department of Dermatology, University of São Paulo, Brazil.

Trigeminal trophic syndrome occurs secondary to trigeminal nerve injury, leading to anaesthesia and paraesthesia, with consequent vigorous facial skin manipulation and lesion production, simulating other facial diseases such as ulcerative discoid lupus erythematosus, tumours and other artificially produced lesions. Ulceration and destruction of the ala nasi is a typical feature besides scratching end excoriations in the cutaneous segment affected. In this series, we present the features of five patients with trigeminal trophic syndrome, highlighting possible confusion with cutaneous lupus. Read More

Postepy Dermatol Alergol 2020 Apr 6;37(2):280-282. Epub 2020 May 6.

Department of Dermatology, University Hospital, Krakow, Poland.

Ann Pathol 2020 Jul 27;40(4):324-328. Epub 2020 Jan 27.

Service de dermatologie, hôpital de la Source, CHR d'Orléans, 14, avenue de l'Hôpital, CS 86709, 45067 Orléans cedex 2, France.

We report the case of a 13-year-old young lady with a one year reccuring bullous dermatitis history for which the diagnostic hypothesis of dermatitis arterfacta was made. This hypothesis was made by the pathologist, without it being suggested by the dermatologist, after observing singular histological lesions coresponding to a cutaneous blister associated with epidermic necrosis with multinucleated keratinocytes. When dermatitis artefacta is suspected, a biopsy is usually conducted to rule out differential diagnosis such as auto-immmune dermatitis when there is a blister. Read More

Skinmed 2019 1;17(5):311-316. Epub 2019 Sep 1.

Department of Dermatology and Venereology, All India Institute of Medical Sciences, Rishikesh, India;

Dermatitis artefacta is a specific psychocutaneous illness, in which the patient creates skin lesions to satisfy the unconscious need to presume a sick role. It is more common in women and in patients with a diagnosis of psychiatric illness/personality disorder (usually borderline) or external stressor. The clinical signs are characteristic and usually present with typical psychiatric manifestations. Read More

Br J Dermatol 2020 04 26;182(4):1063-1064. Epub 2019 Dec 26.

Department of Dermatology, Hospital Universitario de Valme, Sevilla, Spain.

Br J Dermatol 2020 04 25;182(4):1063. Epub 2019 Dec 25.

Department of Dermatology, Allergology and Venereology, Helsinki University Hospital, Helsinki, Finland.

Australas J Dermatol 2020 Feb 11;61(1):e97-e99. Epub 2019 Sep 11.

Anatomical Pathology Department, NSW Health Pathology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.

Dermatitis artefacta is a self-inflicted cutaneous disease presenting as sharply delineated ulcers, usually in accessible sites such as the head and neck. IgG4-related disease (IgG4-RD) is a recently recognised immune-mediated condition causing a fibroinflammatory process, resulting in the formation of tumefactive lesions in various organs, rarely presenting primarily in the skin. We report a case of cutaneous IgG4-RD clinically presenting as dermatitis artefacta. Read More

Dermatol Online J 2019 May 15;25(5). Epub 2019 May 15.

Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL.

Factitious disorder imposed on self is characterized by self-induction. Dermatitis artefacta, the cutaneous subtype of factitious disorder imposed on self, can have a variety of atypical presentations. A 36-year-old woman with an extensive past medical history presented with painful nodules on her abdomen, thighs, and arms. Read More

Clin Dermatol 2019 May - Jun;37(3):268-277. Epub 2019 Jan 11.

Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

The self-induced dermatoses represent about 2% of dermatology patient visits, and include the recurrent body-focused repetitive behaviors (BFRB) (skin-picking or excoriation disorder, trichotillomania, onychophagia and onychotillomania), dermatitis artefacta, and features of other psychiatric disorders, for example, secondary to excessive grooming in body dysmorphic disorder, skin picking in delusional infestation, or secondary to self-harm in depressive disease. Among the BFRBs, onychophagia and onychotillomania are most likely to be associated with lesions that mimic other dermatologic conditions (eg, nail psoriasis, lichen planus, vasculitis, onychomycosis, melanoma). Dermatitis artefacta (DA) describes lesions that are self-inflicted with the intention of assuming a sick role in the absence of obvious external rewards. Read More

Hautarzt 2019 Nov;70(11):883-887

Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.

We present four clinicopathological correlated cases of young patients with cryothermic dermatitis artefacta. They were initially misdiagnosed as primary bullous dermatoses or fixed drug eruptions. Cryothermic dermatitis artefacta can imitate authentic dermatoses such as linear IgA bullous dermatosis, herpes virus infection, bullous pemphigoid or fixed drug eruption. Read More

Australas J Dermatol 2019 Nov 3;60(4):331-333. Epub 2019 Jun 3.

Department of Dermatology, Waikato Hospital, Hamilton, New Zealand.

Reumatologia 2019 29;57(2):106-108. Epub 2019 Apr 29.

Department of Internal Medicine, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil.

A 31-year-old Caucasian woman with a history of anxiety disorder presented with chronic ulcerative lesions of the skin in arms and legs, treated initially as cutaneous vasculitis, evolving with relapsing during corticosteroid tapering, was diagnosed, after thorough investigation and no organic disease found, with dermatitis artefacta - a self-inflicted harm due to psychological disorders. Dermatitis artefacta is a rare condition, more frequent in women, in which traumatic skin lesions are caused by the patient him/herself, over accessible parts of the body, due to personality disorders. Clinicians should be aware of this alternative aetiology, especially as a differential diagnosis for refractory cutaneous vasculitis. Read More

Int Med Case Rep J 2019 18;12:71-73. Epub 2019 Mar 18.

Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991, Moscow, Russia,

Background: The term dermatitis artefacta (factitious dermatitis, pathomimia) is reserved for the most severe variant of factitious physical disorder and is characterized by exaggerated lying (pseudologia fantastica), sociopathy, geographic wandering (peregrinating) from hospital to hospital, and seeking to be in the patient role.

Objective: This report aims to give attention to the importance of accurate and detailed history, and conducting an appropriate physical examination in patients with life-threatening diseases when the underlying cause is not apparent. The diagnosis of dermatitis artefacta must always be upheld. Read More

Indian Dermatol Online J 2019 Jan-Feb;10(1):72

Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

J Cutan Med Surg 2019 May/Jun;23(3):277-281. Epub 2019 Jan 17.

3 Department of Pathology, Dental School, University of São Paulo, Brazil.

Background: The terms exfoliative cheilitis, factitial cheilitis, and morsicatio labiorum are used to describe self-inflicted lesions of the lip.

Objective: Here we report and analyze clinical, pathological, and therapeutic data on 13 patients with a form of factitial cheilitis that we believe should be considered a separate entity.

Results: Eight patients were male and 5 patients were female. Read More

Mil Med 2019 05;184(5-6):e489-e491

Arnot Ogden Medical Center Emergency Medicine Residency Program, 1001 Hoffman St, Elmira, NY.

Penile cellulitis has rarely been reported in the literature and never secondary to self-injury with subsequent sexual activity. It presents a challenging diagnostic situation in that the patient will likely be less than forthcoming about the etiology of his symptoms despite his willingness to seek formal medical attention. We present a case of penile cellulitis secondary to dermatitis artefacta in a severely depressed new submarine sailor. Read More

Clin Dermatol 2018 Nov - Dec;36(6):719-722. Epub 2018 Aug 16.

Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.

Dermatitis artefacta, also known as factitial dermatitis, is a condition whereby self-induced skin damage is the means used to satisfy a conscious or unconscious desire to assume the sick role. It is particularly common in women and in those with an underlying psychiatric diagnosis or external stress. The diagnosis is one of exclusion, and it is often difficult to confirm, with patients rarely admitting their role in the creation of their lesions. Read More

Ann Dermatol Venereol 2019 Feb 22;146(2):135-140. Epub 2018 Oct 22.

Département de dermatologie et vénéréologie, hôpital Bel-Air, CHR Metz-Thionville, 57000 Thionville, France.

Background: Factitious disorders constitute a complex pathology for the dermatologist. Although a diagnosis is often indicated, it is difficult to confirm and treatment is complicated. Dermatitis artefacta is the somatic expression of an often serious psychiatric disorder consciously created by patients on their own cutaneous-mucosal surfaces but the motivation is unconscious and no secondary benefits are sought (in contrast to simulation). Read More

J Dtsch Dermatol Ges 2018 May 24;16(5):559-564. Epub 2018 Apr 24.

Department of Dermatology, Jena University Hospital, Jena, Germany.

Background: Dermatitis artefacta is a relevant and frequently unrecognized clinical condition associated with self-harming behavior, in which unconscious manipulation causes skin lesions. While atypical lesions and an unusual disease course may give rise to clinical suspicion of a self-induced disorder, questioning and examining these patients usually fails to confirm or clarify this suspicion. In this setting, the dermatopathologist may be faced with the question whether there are any histological signs corroborating the diagnosis of dermatitis artefacta. Read More

G Ital Dermatol Venereol 2018 Aug 19;153(4):525-534. Epub 2018 Apr 19.

Department of Dermatology, Royal London Hospital, London, UK -

Dermatitis artefacta (DA) or artefactual skin disease (ASD) is a factitious skin disorder rarely reported in the pediatric population. Skin lesions are produced deliberately either consciously or in a dissociative state to satisfy an underlying psychological need. Children may present with acutely formed skin changes or with chronic lesions, quite often having seen other specialists during their journey. Read More

Rev Med Liege 2017 Dec;72(12):521

Service de Psychiatrie, Centre Hospitalier Universitaire Mohammed VI, Faculté de Médecine et de Pharmacie, Université Mohammed premier, Oujda, Maroc.

J Dermatolog Treat 2018 Jun 5;29(4):418-427. Epub 2017 Nov 5.

c Psychiatry and Neurology Department , Florida Atlantic University Charles E. Schmidt College of Medicine , Boca Raton , FL , USA.

Approximately half of all patients presenting to dermatologists exhibit signs and symptoms of psychiatric conditions that are either primary or secondary to cutaneous disease. Because patients typically resist psychiatric consult, dermatologists often are on the front line in evaluating and treating these patients. Accordingly, distinguishing the specific underlying or resulting psychiatric condition is essential for effective treatment. Read More