Professional paper
Dermatitis Artefacta: A Practical Guide for Diagnosis and Management
Julio Torales
; Universidad Nacional de Asunción, San Lorenzo, Paraguay
Karina Malvido
; Center for Continuing Medical Education and Clinical Research “Norberto Quirno”,
María Alejandra Vázquez
; Independent Researcher, Buenos Aires, Argentina
Iván Barrios
; Universidad Nacional de Asunción, San Lorenzo, Paraguay
José Almirón-Santacruz
; Universidad Nacional de Asunción, San Lorenzo, Paraguay
Rodrigo Navarro
; Universidad Nacional de Asunción, San Lorenzo, Paraguay
Marcelo O’higgins
; Universidad Nacional de Asunción, San Lorenzo, Paraguay
Gabriel Casas
; Department of Pathology, School of Medical Sciences University of Buenos Aires, Buenos Aires, Argentina
João Mauricio Castaldelli-Maia
; Universidad de Sao Paulo, Brazil
Antonio Ventriglio
; University of Foggia, Fogia, Italy
Israel González-Urbieta
; North East London NHS Foundation Trust, London, United Kingdom
Abstract
ABSTRACT Dermatitis artefacta (DA) is a psycho-dermatologic condition
based on patients’ behavioral patterns, characterized by an intentional pro-
duction of cutaneous lesions on their own skin. The clinical presentation
can be highly variable. Patients with DA seldom seek psychological support
or psychiatric consultation. More often, they seek help from their primary
care physician or dermatologist. This review article aims to provide a practi-
cal guide for the diagnosis and management of AD and affected patients. A
broad literature search was performed using the PubMed and Google Schol-
ar electronic online databases, using key words “dermatitis artefacta”, “diag-
nosis”, “management”, and “psychodermatology”. The search was limited to
English and Spanish language articles and was supplemented with themed
books and book chapters. DA can occur in a variety of clinical presentations,
and physicians should suspect DA in patients with a history of psychiatric
disorders or extensive use of healthcare services. The ultimate goal of DA
treatment may be a proper referral to mental health services. However, the
prognosis is poor even when successful mental health referrals are achieved,
with low recovery rates. A useful approach may include the suggestion that a
mental health provider can help with the anxiety and the distress generated
by the lesions: in this case in this case it will be crucial to discuss this with the
mental health provider after obtaining informed consent from the patient.
Considering the difficulty in promoting patients’ adherence to treatment, the
ideal setting for DA treatment is a psycho-dermatologic clinic, where both
dermatologic and psychological interventions can be seamlessly integrated.
Keywords
dermatitis artefacta; psychodermatology; psychopathology; diagnosis
Hrčak ID:
311535
URI
Publication date:
16.3.2023.
Visits: 223 *