Bullous Dermatitis Artefacta

  • Marcel F. JonkmanEmail author


Bullous dermatitis artefacta is a psychodermatologic factitious disorder in patients who mimic skin disease by inflicting themselves with blisters. The diagnosis is often apparent at first visit. The diagnosis should never be immediately revealed to the patient. Instead a serious, yet limited, workup is advised while developing a trustful patient-doctor relation. The strategy is to give the patient the impression you know it was self-inflicted but leaving an escape for clearance by trivial causes imagined by the patient such as avoiding drinking coffee (narrow escape). In refractory cases, when confrontation becomes unavoidable, dual approach by dermatologists and psychiatrists is necessary.


Factitious disorder Psychodermatology Self-injury Munchausen syndrome 


  1. 1.
    Brehmer-Andersson E, Goransson K. Friction blisters as a manifestation of pathomimia. Acta Derm Venereol. 1975;55:65–71.PubMedGoogle Scholar
  2. 2.
    van Rijssen A, Molier L, Vrijlandt AJ, Jonkman MF. Bullous dermatitis self-induced. Ned Tijdschr Geneeskd. 2000;144:1465–9.PubMedGoogle Scholar
  3. 3.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th text rev ed. ed. Washington, DC: American Psychiatric Association; 2000.Google Scholar

Additional Reading

  1. Harth W, Gieler U, Kusnir D, Tausk FA. Clinical management in psychodermatology. New York: Springer; 2009. ISBN 978-3-540-34719-4.Google Scholar
  2. Harth W, Taube K-M, Gieler U. Facticious disorders in dermatology. J Dtsch Dermatol Ges. 2010;8:361–72.PubMedGoogle Scholar
  3. Gieler U, Consoli SG, Tomás-Aragones L, Linder DM, Jemec GBE, Poot F, Szepietowski JC, De Korte J, Taube KM, LVoV A, Consoli SM. Self-Inflicted lesions in dermatology: terminology and classification–a position paper from the European Society for Dermatology and Psychiatry (ESDaP). Acta Dermatol Venereol. 2013;93:4–12.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of DermatologyCenter for Blistering Diseases, University Medical Center Groningen, University of GroningenGroningenthe Netherlands

Personalised recommendations