Factitious Skin Disorder (Dermatitis Artefacta)

Millard, Jonathan A.; Millard, L.G.

doi:10.1002/9781118560648.ch17

Cited by 7 publications

(8 citation statements)

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“…Since these patients differ from the rest of dermatological patients and the underlying psychological component is crucial, these factors should be kept in mind by the physician. Numerous psychological/psychiatric conditions can be found in association with SISL, but in most cases 3 groups are encountered: adjustment disorders, depressive disorders and personality disorders [3]. The frequency of emotional disorders in dermatological patients has been reported to range between 25.2% and 33.4% [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

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Self-inflicted skin lesions: the importance of a proper diagnostic and therapeutic approach

Dimitrov¹,

Reszke²,

Szepietowski³

2016

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Introduction. Patients with self-inflicted skin lesions (SISL) are most often referred to dermatologists. Since psychological and psychiatric conditions might be the underlying reasons for the behavior of these patients, the psychology-associated component should always be kept in mind when approaching such individuals. Objective. To discuss distinctive aspects of the approach towards patients with SISL and emphasize the most relevant issues concerning the management of psychodermatoses. Case report. We present a case of a 13-year-old girl with a 6-month history of skin lesions misdiagnosed as allergic contact dermatitis. Conscientious history taking and physical examination enabled the diagnosis of SISL. Conclusions. The proper approach to patients presenting with psychodermatoses differs from that for other dermatological patients and requires considering several additional aspects. We would like to emphasize the distinguishing aspects and importance of the proper approach to patients with SISL that might aid clinicians in diagnosing and treating these individuals in the future. streszczenie Wprowadzenie. Pacjenci z dermatozą wywołaną są zwykle kierowani do dermatologów. Schorzenia o podłożu psychologicznym i psychiatrycznym mogą wpływać na zachowanie pacjentów, dlatego należy zawsze rozważyć czynniki związane z psychiką w postępowaniu z takimi osobami. Cel pracy. Omówienie szczególnych aspektów podejścia do pacjenta z objawami samouszkodzeń i podkreślenie najważniejszych odmienności w postępowaniu z pacjentami z psychodermatozami. Opis przypadku. Opisujemy przypadek 13-letniej dziewczynki, u któ-rej od 6 miesięcy rozwijały się zmiany skórne błędnie diagnozowane jako alergiczne kontaktowe zapalenie skóry. Dokładne zebranie wywiadu od rodziców wraz z badaniem fizykalnym umożliwiło ustalenie rozpoznania dermatozy wywołanej. Wnioski. Prawidłowe podejście do pacjentów z psychodermatozami różni się od podejścia do pacjentów z pozostałymi schorzeniami skór-self-inflicted skin lesions: the importance of a proper diagnostic and therapeutic approach Dermatoza wywołana -znaczenie prawidłowego podejścia diagnostycznego i leczniczego

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Section: Discussionmentioning

confidence: 99%

“…In contrast, patients with SISL are characterized by a so-called "hollow history". The dermatological condition supposedly appeared suddenly and exacerbation occurred without anybody witnessing it, apart from the patients themselves [3].…”

Section: Introductionmentioning

confidence: 99%

Self-inflicted skin lesions: the importance of a proper diagnostic and therapeutic approach

Dimitrov¹,

Reszke²,

Szepietowski³

2016

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“…Focusing on the possibility that lesions may be self-induced may lead to a break down in the patient–clinician relationship (Millard 2014). Instead the clinician should take time to develop a rapport, identify any stressors and treat underlying psychiatric or psychological disorders.…”

Section: Psychiatric Disorders With Dermatological Symptomsmentioning

confidence: 99%

“…Instead the clinician should take time to develop a rapport, identify any stressors and treat underlying psychiatric or psychological disorders. The psychiatric disorders most frequently associated with dermatitis artefacta are personality disorder, adjustment disorder and depression (Millard 2014). Personality disorder is seen in at least one-third of patients (most commonly, emotionally unstable or histrionic personality disorder) and will be suggested by a history consistent with the disorder and/or multiple previous contacts with healthcare services, especially mental health services (Casey 2007: pp.…”

Section: Psychiatric Disorders With Dermatological Symptomsmentioning

confidence: 99%

An introduction to the assessment and management of psychodermatological disorders

2020

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SUMMARY Psychodermatology is an emerging field at the interface between psychiatry, psychology and dermatology. There is a strong bidirectional relationship between a number of dermatological disorders and psychiatric disorders. This article provides an overview of psychiatric disorders with dermatological symptoms, and dermatological disorders with secondary psychophysiological consequences. The principles of management and our insights into establishing a psychodermatology service in the UK are discussed.

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“…DA is a form of factitious disorder in which patients generate their own skin disease while hiding their actions from clinicians. 4 It is invariably associated with a comorbid psychological or mental health disorder, and may be considered 'a cry for help'. At its heart, the job of the clinician is to tease out, cautiously and sensitively, what is going on in the patient's life to drive such an extreme response.…”

Section: Dermatitis Artefactamentioning

confidence: 99%