Dermatitis Artefacta in Childhood: A Retrospective Analysis of 44 Patients, 1976–2006

Abstract

Background: Dermatitis artefacta (DA) consists of self-inflicted skin lesions that the patient denies having produced. Objectives: To conduct a single-center retrospective clinical review of children and adolescents diagnosed with DA. Methods: From 1976 to 2006, data were collected on children diagnosed with DA who were seen in the Department of Dermatology in our hospital. Clinical and epidemiologic features are described. Forty-four children (mean age 12.9 yrs) were selected, representing 21.9% of the total patients with DA recorded (n = 201) during this period. . Sixteen were located exclusively on the face and neck, whereas 28 also had other locations (upper limbs, n = 10; lower limbs, n = 9; thorax, n = 5; abdomen, n = 4). Cutaneous lesions were treated with occlusive bandages using zinc paste or a plaster splint when necessary. Conclusion: To our knowledge, this is the largest reported series of DA in childhood. This complicated psychodermatologic condition requires correct diagnosis, appropriate management, and psychiatric assessment.

Attention deficit hyperactivity disorder presenting as dermatitis artefacta

“…The dermatologic manifestation in our case is similar to superficial skin lesions in face and upper limbs as reported in literature. [ 8 ] Interpersonal conflicts with siblings and parent are often the underlying stressors as was in our patient. [ 4 5 ]…”

Treatment of Dermatitis Artefacta: A Systematic Review

“…The other 14 patients (51.9%) declined psychiatric evaluation and were subsequently lost to follow-up. 11 In the second study looking at a subset of the 201 patients with DA, Alcántara Luna et al 13 identified paediatric patients diagnosed with DA over the same 30-year time period. There were 44 children and adolescents, with a mean age of 12.9 years.…”

“…Out of these patients, two had psychiatric diagnoses, including a personality disorder and history of suicide attempt. 13 A prospective study was carried out to investigate DA among members of the Israel Defence Force (IDF). Over a 3-year period, from 1997-2000, 14 soldiers were treated.…”

A 14-year-old with dermatitis artefacta secondary to aerosolized spray deodorant: A rare case with an important learning opportunity

“…In a retrospective analysis of 44 pediatric patients with DA from 1976 to 2006, the most frequent clinical forms were excoriations, ulcers, and blisters, which were prominent in our case. 6 The appearance of DA lesions vary, and superficial erosion, hyperpigmented macules, excoriation, deep necrosis, crusts, and scars make up approximately 50%, 36%, 17%, 16%, 8%, and 7% of lesions, respectively. Overall, about 72% of the patients have 1 type of lesion morphology, while 41% have 2 types and 31% have 3 types.…”