Kwon Eun Ji, Dans Michael, Koblenzer Caroline S, Elenitsas Rosalie, James William D
Department of Dermatology, University of Pennsylvania Health System, Philadelphia, PA, USA.
J Cutan Med Surg. 2006 Mar-Apr;10(2):108-13. doi: 10.2310/7750.2006.00023.
Dermatitis artefacta (DA) is difficult to diagnose by clinical findings alone. Histopathologic analysis may rule out organic disorders and in some cases establish, in conjunction with microanalytic techniques, a definite diagnosis.
We report a young woman with DA in the form of recurrent abscesses whose diagnosis was aided by the identification of subcutaneous foreign material through histologic and microanalytic methods.
Histologic examination showed foreign body giant cell reaction with polarizable material, which was identified as cellulose by energy dispersive x-ray analysis and Fourier transform infrared spectrometry.
Self-injection of exogenous matter was suspected. Referral to an expert in psychodermatology resulted in the diagnosis of multiple psychiatric comorbidities commonly associated with DA. Initiation of antidepressants resulted in marked improvement in her skin disease, as well as her mood and affect.
We emphasize the importance of interdisciplinary collaboration between dermatologists, dermatopathologists, and mental health professionals in the management of DA.
人工皮炎（DA）仅通过临床表现很难诊断。组织病理学分析可排除器质性疾病，在某些情况下，结合微量分析技术可明确诊断。
我们报告一名年轻女性，以复发性脓肿形式出现人工皮炎，通过组织学和微量分析方法鉴定皮下异物辅助诊断。
组织学检查显示有异物巨细胞反应及可极化物质，通过能量色散X射线分析和傅里叶变换红外光谱法鉴定为纤维素。
怀疑有外源性物质自我注射。转诊至精神皮肤病学专家后，诊断出与人工皮炎相关的多种精神共病。开始使用抗抑郁药后，其皮肤病以及情绪和情感均有显著改善。
我们强调皮肤科医生、皮肤病理学家和心理健康专业人员之间跨学科合作在人工皮炎管理中的重要性。
