Frasier Kelly M, Fritts Haily A, Li Vivian, Dudzik Christina, Sobotka Michelle, Click Kathleen, Loperfito Alexandra
Dermatology, Northwell Health, New Hyde Park, USA.
Dermatology, Idaho College of Osteopathic Medicine, Meridian, USA.
Cureus. 2024 Oct 16;16(10):e71616. doi: 10.7759/cureus.71616. eCollection 2024 Oct.
This comprehensive review critically examines the complex relationship between Munchausen Syndrome by Proxy (MSBP) and its dermatological manifestations, uncovering new insights into the relatively uncharted territory of this psychiatric disorder. By synthesizing existing literature, case studies, and clinical observations, this paper reveals the multifaceted spectrum of dermatological phenomena seen in individuals affected by MSBP, ranging from self-inflicted injuries to entirely fabricated skin conditions. Additionally, we explore the psychological and behavioral mechanisms driving caregivers to induce or stimulate dermatological symptoms, shedding light on underlying psychopathologies, the nuanced dynamics of the caregiver-patient relationship, and patterns of pathological attachment and dependency. This review confronts the significant obstacles healthcare providers encounter in accurately identifying dermatological symptoms related to MSBP amidst genuine dermatologic conditions, underscoring the indispensable role of a multidisciplinary strategy and heightened clinical vigilance in these complex cases. Future investigations call for the development of standardized assessment tools, the potential of biomarkers for early detection, the exploration of the neurobiological basis of MSBP, and the utilization of specific interventions to protect susceptible populations while improving the accuracy of MSBP diagnoses. This paper calls for a more informed, sensitive, and proactive approach to better understanding and treating the dermatological manifestations of MSBP.
本综述批判性地审视了代理型孟乔森综合征(MSBP)与其皮肤表现之间的复杂关系,揭示了关于这种精神疾病相对未知领域的新见解。通过综合现有文献、病例研究和临床观察,本文揭示了受MSBP影响的个体中所见皮肤现象的多方面情况,从自我伤害到完全编造的皮肤病症。此外,我们探讨了促使照料者诱发或刺激皮肤症状的心理和行为机制,阐明了潜在的精神病理学、照料者与患者关系的细微动态以及病理性依恋和依赖模式。本综述指出了医疗保健提供者在真正的皮肤病情况下准确识别与MSBP相关的皮肤症状时遇到的重大障碍,强调了多学科策略和提高临床警惕性在这些复杂病例中的不可或缺作用。未来的研究需要开发标准化评估工具、探索生物标志物用于早期检测、探究MSBP的神经生物学基础以及利用特定干预措施来保护易感人群,同时提高MSBP诊断的准确性。本文呼吁采取更明智、敏感和积极主动的方法,以更好地理解和治疗MSBP的皮肤表现。