Last Updated: 2023-07-07
Author(s): Anzengruber F., Navarini A.
Dermatitis artefacta, dermatitis factitia, pathomimia, automutilation, hysterical skin gangrene, self inflicted skin injuries.
Self-induced skin lesions due to a mental disorder.
- Mostly women
- 2% of all patients in dermatology practice
- Age peak 20th-40th year of life
- Simulations: Deliberately caused skin lesions in order to gain certain advantages, i.e. secondary gain of illness (sick leave, pity)
- For example: Munchausen syndrome
- Paraartefacts: self-inflicted injuries, without intent to deceive, due to mental illness
- Real artefacts: Arising from a progressive, internal tension, which is eradicated by skin manipulation
Different mental disorders.
Only skin locations that can be easily reached by the hands are affected. There is usually a side preference (always ask the patient if he is right- or left-handed). Manipulations are usually performed on the contralateral side. Primary efflorescences are not visible. Both hands, nails, knives or even toxic substances can be used.
Diagnoses of exclusion.
If suspected, perform a biopsy to exclude pyogderma gangraenosum.
- Koblenzer CS. NEUROTIC EXCORIATIONS AND DERMATITIS ARTEFACTA. Dermatologic Clinics 1996;14:447-56.
Michael J. Lavery et al. Dermatitis artefacta. Clin Dermatol Nov-Dec 2018;36(6):719-722.