Holt Peter, El-Dars Leila, Kenny Alice, Lake Amy
Welsh Institute of Dermatology, University Hospital of Wales, Cardiff, UK.
J Vis Commun Med. 2013 Jun;36(1-2):31-4. doi: 10.3109/17453054.2013.791255.
A patient is described with dermatitis artefacta, which is a common psychocutaneous disorder whereby a fully-aware patient self-inflicts injury to their skin. The motives for their behaviour can vary and the patient always tries to hide the responsibilities for their actions. In this case report, serial use of standardised photography provided strong evidence to support the diagnosis of dermatitis artefacta. The fluorescent properties of Trimovate® Cream under Wood's light examination corroborated the diagnosis. Trimovate® Cream was applied to the skin surrounding the injuries and the limb was occluded with four layers of bandages. Traces of Trimovate® Cream were seen under Wood's light on the outer layers of the bandage. This suggested transfer of the cream from the occluded skin surface by the patient's fingers whilst tampering with the dressings. This case report shows how serial photography and imaging using ultraviolet (UV) fluorescence can provide evidence to support the diagnosis of dermatitis artefacta.
本文描述了一名人工皮炎患者，人工皮炎是一种常见的精神性皮肤病，即意识完全清醒的患者自行对自己的皮肤造成损伤。其行为动机各不相同，且患者总是试图隐瞒其行为的责任。在本病例报告中，连续使用标准化摄影提供了强有力的证据支持人工皮炎的诊断。在伍德灯检查下，适确得乳膏（Trimovate® Cream）的荧光特性证实了诊断。将适确得乳膏涂抹在伤口周围的皮肤上，并用四层绷带包扎肢体。在伍德灯下，在绷带外层发现了适确得乳膏的痕迹。这表明在患者摆弄敷料时，乳膏从被包扎的皮肤表面通过手指转移了。本病例报告展示了连续摄影和利用紫外线（UV）荧光成像如何能够提供证据支持人工皮炎的诊断。
