Kępska Anna, Majtyka Magdalena, Kowman Maciej, Kłoszewska Iwona, Kwiecińska Ewa, Zalewska-Janowska Anna
Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Poland. Head of Department: Prof. Iwona Kłoszewska MD, PhD ; Psychodermatology Department, Medical University of Lodz, Poland. Head of Department: Prof. Anna Zalewska-Janowska MD, PhD.
Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Poland. Head of Department: Prof. Iwona Kłoszewska MD, PhD.
Postepy Dermatol Alergol. 2014 Aug;31(4):277-9. doi: 10.5114/pdia.2014.40921. Epub 2014 Sep 8.
Dermatitis artefacta is a disease that occurs as a result of a self-inflicted injury of the skin. The skin lesions are most often located on the areas within easy reach of the patient's dominant hand sparing the middle part of the back. Dermatitis artefacta may coexist with psychiatric disorders and imitate many dermatologic diseases. As most of the patients with self-inflicted dermatoses usually initially deny any psychiatric problems, what delays psychiatric intervention, they are typically first seen by dermatologists. We are reporting a case of a 35-year-old man with a 3-year-long history of schizophrenia who has been treated at a dermatologist's office sequentially with acne, bacterial lesions, suspected tuberculosis. However, the treatment was ineffective. He was diagnosed with dermatitis artefacta after 7 years of disease duration. During this time he was treated with many medicines e.g. isotretinoin, which is contraindicated in psychosis as it worsens the course of disease. After establishing the correct diagnosis and antipsychotic treatment, a significant improvement was obtained in both skin condition and mental state. These are the reasons why we would like to recommend close cooperation between dermatologists and psychiatrists.
人工皮炎是一种因患者自我造成皮肤损伤而发生的疾病。皮肤病变最常位于患者优势手可触及的部位，背部中间部分除外。人工皮炎可能与精神障碍并存，并可模仿多种皮肤病。由于大多数患有自我造成的皮肤病的患者最初通常否认有任何精神问题，这延误了精神科干预，他们通常首先由皮肤科医生诊治。我们报告一例35岁男性，有3年精神分裂症病史，曾先后在皮肤科诊所接受痤疮、细菌性皮损、疑似结核的治疗。然而，治疗无效。病程7年后他被诊断为人工皮炎。在此期间，他接受了多种药物治疗，如异维A酸，而该药在精神病患者中是禁忌的，因为它会使病情恶化。在确立正确诊断并进行抗精神病治疗后，皮肤状况和精神状态均有显著改善。这些就是我们建议皮肤科医生和精神科医生密切合作的原因。
