Department of Dermatology, Barts Health NHS Trust, Royal London Hospital, London, UK.
Clin Exp Dermatol. 2013 Dec;38(8):921-3. doi: 10.1111/ced.12179. Epub 2013 Jun 13.
Dermatitis artefacta (DA), a factitious skin disorder, often occurs as a response to traumatic life events or as a factitious behaviour, which may result in secondary gain. It can be difficult to get patients to engage with health services, and they seldom admit to causing the lesions themselves. The possibility of DA lesions occurring in dissociative states is less well known. We present a case of DA diagnosed in a vulnerable adult, who we believe caused the lesions during periods of dissociation. We discuss the way in which the concept of dissociation can provide an acceptable way of discussing the behaviour with patients and initiating psychological therapy.
人为性皮炎（DA）是一种人为的皮肤疾病，通常是对创伤性生活事件的反应，或是一种人为的行为，可能导致继发获益。让患者接受医疗服务可能很困难，他们很少承认自己造成了这些损伤。人们对分离状态下可能出现 DA 病变的认识较少。我们报告了一例在易受伤害的成年人中诊断出的 DA 病例，我们认为该患者在分离期间造成了这些损伤。我们讨论了分离概念如何为与患者讨论这种行为并启动心理治疗提供一种可接受的方式。
