Factitious Disorders (Dermatitis Artefacta)

Abstract

Factitious disorders (FDs) or dermatitis artefacta is characterized by self-inflicted lesions on dominant hand approachable sites of the body. The symptoms are produced voluntarily and consciously with no intention of secondary gain. Patients produce lesions by several means including by mechanical causes such as by pressure, friction, occlusion, biting, cutting, stabbing, and mutilation. Some patients produce lesions by toxic damage such as using acids, alkalis, and thermal causes. Morphologically lesions are bizarre, geometrical, and not conforming to any recognized skin disease. Most commonly, these lesions are seen in females. Associated psychiatric comorbidity and psychosocial stressors are always present. Treatment would require a multidisciplinary team of a dermatologist, psychiatrist, primary care physician, therapist, social worker, and family members. Empathic and nonjudgmental approach is always necessary.