Last Updated: 2020-08-13

Author(s): Anzengruber, Navarini

Dermatitis artefacta, dermatitis factitia, pathomimia, automutilation, hysterical skin gangrene, self inflicted skin injuries.

Self-induced skin lesions due to a mental disorder.

  • Almost only women.
  • 2% of all patients in the dermatological practice.
  • Age peak 20 - 40 years of age.
  • Simulations: Deliberately caused skin lesions in order to gain certain advantages, i.e. secondary disease gain (sick leave, pity).
  • e.g.: Munchausen's syndrome 
    • Para-artefacts: self-inflicted injuries, without intent to deceive, due to mental illness.
    • Real artefacts: Created by a progressive, internal tension, which is eliminated by skin manipulation.

Different mental disorders.

Only skin localizations which are easily accessible by hands are affected. There is usually a side preference (always ask the patient whether he is right- or left-handed). In most cases the manipulations take place on the contralateral side. Primary efflorescences are not visible. Hands, nails, knives or even toxic substances can be used.

Rule-out diagnoses.

  • Zinc paste dressings or other occlusive dressings
  • Psychotherapy
  1. Koblenzer CS. NEUROTIC EXCORIATIONS AND DERMATITIS ARTEFACTA. Dermatologic Clinics 1996;14:447-56.