Factitious dermatitis

Abstract: Self-induced factitial dermatitis, or dermatitis artefacta, is a rare and difficult condition to treat. We present an unusual case of factitious dermatitis with its subsequent severe complications. The clinical features, radiographic findings, histopathologic features, and treatment options are reviewed.

Abstract: • Certain dermatoses that are generally recognized as affected by psychogenic stimuli were treated with hydroxyzine hydrochloride, a tranquilizing drug administered by mouth. The initial dosage was 10 mg. four times a day in 48 patients and 25 mg. four times a day in 111 patients. The ataraxic (relaxing) effect, as judged from the statements by the patients, was satisfactory in 132 and fair or insignificant in 27. The condition of the skin was evaluated objectively in 41 patients who had general atopic dermatitis, localized neurodermatitis, pruritus ani, or factitious dermatitis and who were given the drug and a placebo alternately. Of the 41, 36 showed clinical improvement while taking the drug and recrudescence while taking the placebo. Side-effects, which included headache, sleepiness, dryness of the mouth, and itching, were generally infrequent and mild. In one case the headache made it necessary to discontinue giving the drug. No evidence of damage to the blood, kidneys, or liver was seen in patients who took the drug for six weeks or more. The demonstrated tension-relieving action of the drug explained the objective evidence of its usefulness in dermatology.

Abstract: 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. Case presentation We present a unique case of a 52-year-old male who presented to clinic with skin lesions on scrotum and shaft of his penis and that were very distinct and suggestive of pyoderma gangrenosum which he developed 3 months after previous discharge from the clinic. Clinical response to treatment and the absence of laboratory findings confirmed a dermatitis artefacta. Conclusion Dermatitis artefacta is a factitious disorder that involves falsification of psychological or physical signs or symptoms caused entirely by the patients themselves, in a clear state of consciousness, in order to play the role of a sick person. The correlation of anamnestic data and clinical and para-clinical exams was essential for the diagnosis of dermatitis artefacta in this case. To the best of our knowledge, pyoderma gangrenosum-like lesions have never been reported in a patient with dermatitis artefacta. Herein, we describe a rare case report of self-inflicted genital injury in a 52-year-old male.

Abstract: Two 18-year-old men were seen for second-degree burns to the dorsum of their knees, ankles, and feet. Upon investigation, it was revealed that the burns were self-inflicted and resulted from the application of crushed garlic with the intent of exemption from work. Reviews of the literature reveal that garlic-induced burns have been previously reported; however, only once before as a factitious dermatitis. The sharp demarcation line between normal and abnormal skin should suggest that a burn is not from hot liquids. Health care providers had best be advised of the side effects of natural remedies and be aware of how garlic may be abused to the advantage of an individual.