Sung Calvin, Salem Secilia, Nguyen Ethan, Koo John
Dr. Sung is with the Department of Dermatology, University of California Irvine in Irvine, California.
Ms. Salem is with the University of California Riverside School of Medicine in Riverside, California.
J Clin Aesthet Dermatol. 2021 May;14(5):22-24. Epub 2021 May 1.
Factitious disorders and factitious disorders imposed on another are a prevalent encounter during dermatology visits. Here, we present a case of a pediatric patient who presented with ulcer-like lesions that, based on initial biopsy, suggested an immunobullous etiology. Further exploration revealed her underlying psychiatric disorder. Dermatologists play an integral role in recognizing and initiating "nervous system" management to establish a level of trust with the patient that will ultimately allow bridging to psychiatric care. The case discussed here serves as an example of the successful diagnosis and treatment of a pediatric psychiatric patient by raising clinical suspicion, using investigative techniques, employing separate interviews and the Patient Health Questionnaire-9, and sensitively addressing the relationship between the patient, guardian, and provider within the dermatology clinic.
在皮肤科就诊过程中，人为性障碍和对他人施加的人为性障碍是常见的情况。在此，我们报告一例儿科患者，该患者出现溃疡样病变，根据初始活检结果提示为免疫性大疱性病因。进一步检查发现了其潜在的精神疾病。皮肤科医生在识别并启动“神经系统”管理方面发挥着不可或缺的作用，以与患者建立一定程度的信任，最终实现向精神科护理的过渡。本文讨论的病例通过提高临床怀疑度、运用调查技巧、采用单独访谈和患者健康问卷-9，并在皮肤科诊所中敏感地处理患者、监护人及医护人员之间的关系，成功诊断并治疗了一名儿科精神疾病患者。
