Student Scientific Association in Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland.
Med Sci Monit. 2012 Oct;18(10):CS85-9. doi: 10.12659/msm.883474.
Dermatitis artefacta (DA) is a dermatologicopsychiatric illness that is a conscious self-infliction of lesions to accessible regions of the body. The lesions usually do not resemble those of any know skin disease and there are no specific diagnostic tests to recognize them. This makes dermatitis artefacta a very slow, challenging and expensive disease to diagnose.
We present 5 different clinical cases of dermatitis artefacta treated in the Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk in 2011. Detailed anamnesis and physical examination were performed at the day of admission. All patients had biochemical and hematological blood tests, skin biopsies and swabs for bacteriological examination, and photographs were taken. Psychiatric consultation was recommended in all cases. Clinical symptoms before diagnosis lasted from 1 to 10 years. The female-to-male ratio is 1:0.7, with age range of 57-62 years. Of our patients, only 2 refused a psychiatric consultation. Three out of 5 patients denied self-mutilation (2 of those 3 patients finally admitted to self-manipulations). Lesions were usually within the reach of the dominant hand. Two patients have other personality disorders. In 4/5 cases visible improvement after treatment with occlusive dressings were observed.
We discuss and attempt to depict issues associated with collaboration between dermatologists and psychiatrists, reasons for poor recognition of the disease, very long diagnosis and high costs. To conclude, we found that close collaboration between dermatologists and psychiatrists is important in diagnosing and treating DA patients.
人工性皮肤病（DA）是一种皮肤科-精神病学疾病，是有意识地将病变施加于身体可触及的区域。病变通常与任何已知的皮肤病都不一样，也没有专门的诊断测试来识别它们。这使得人工性皮肤病的诊断非常缓慢、具有挑战性和昂贵。
我们在 2011 年展示了 5 例不同的人工性皮肤病临床病例，这些病例均在格但斯克医科大学皮肤科、性病学和变态反应科治疗。入院当天进行了详细的病史采集和体格检查。所有患者均进行了生化和血液学检查、皮肤活检和细菌学检查拭子，并拍摄了照片。建议所有患者进行精神病学咨询。诊断前的临床症状持续 1 至 10 年。男女比例为 1:0.7，年龄范围为 57-62 岁。我们的患者中只有 2 人拒绝接受精神病学咨询。5 名患者中有 3 名否认自残（这 3 名患者中有 2 名最终承认自残）。病变通常在惯用手可触及的范围内。2 名患者有其他人格障碍。在 5 例中有 4 例观察到在使用密闭敷料治疗后有明显改善。
我们讨论并试图描述与皮肤科医生和精神病医生合作、疾病识别不佳、诊断时间长和成本高相关的问题。总之，我们发现皮肤科医生和精神病医生之间的密切合作对于诊断和治疗 DA 患者非常重要。
