Factitious disorders in dermatology: Value of the dissociative state concept

Annales de dermatologie et de vénéréologie
F Fekih-RomdhaneR Labbane

Abstract

Factitious disorders in dermatology consist of intentionally self-inflicted skin lesions that vary in morphology and distribution and occur on surfaces readily accessible to the patient's hands. They tend to be a chronic condition that waxes and wanes according to the circumstances of the patient's life. Patient management poses a particular challenge to the clinician and the prognosis is considered poor. The aetiopathogenesis of factitious disorders in dermatology is not completely understood. We present a case in which we suggested the occurrence of factitious behaviour during a dissociative state, and we briefly describe our diagnostic and therapeutic approach. A 48-year-old unemployed woman was referred to our department of psychiatry by her dermatologist for suspected factitious disorder. The patient was diagnosed with diabetes mellitus type 1 and had been hospitalized repeatedly for confirmed diabetic ketoacidosis. The onset of the disease was related to marital discord with her spouse. Numerous skin lesions had appeared on her face, arms, legs, neck and back. These lesions resulted in multiple hospital admissions and in amputation of her left leg. The condition had worsened considerably after her separation from her husb...Continue Reading

References

Mar 3, 2001·Behaviour Research and Therapy·H Merckelbach, P Muris
Feb 15, 2002·Journal of the European Academy of Dermatology and Venereology : JEADV·M A Gupta, A K Guptat
Jun 5, 2003·The American Journal of Psychiatry·Lois E KrahnM Kevin O'Connor
Mar 16, 2011·Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry·Allan Tasman
Mar 22, 2014·Clinical Interventions in Aging·Anca ChiriacCaius Solovan

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