From the Research
Dermatitis artefacta is a psycho-dermatologic condition characterized by intentional production of cutaneous lesions, requiring a multidisciplinary approach for treatment, including antidepressants, anxiolytics, and psychotherapy, with the ultimate goal of addressing underlying psychological distress. The clinical presentation of dermatitis artefacta can be highly variable, with patients often seeking help from primary care physicians or dermatologists rather than psychological support or psychiatric consultation 1. Key features of patient presentation include:
- Unusual skin lesions with geometric shapes, sharp borders, and bizarre patterns
- Lesions appearing in easily accessible body areas, with various stages of healing
- Patients characteristically remaining indifferent about their condition and providing vague histories regarding the lesions' development Treatment options may include:
- Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, or escitalopram
- Anxiolytics like benzodiazepines, used cautiously due to dependency risks
- Psychotherapy, particularly cognitive-behavioral therapy (CBT) and dialectical behavior therapy, to identify underlying psychological triggers and develop healthier coping mechanisms The therapeutic relationship must be non-confrontational, avoiding direct accusation of self-harm, which can lead to denial and treatment abandonment 1, 2. Successful management focuses on addressing underlying psychological distress, rather than simply treating skin manifestations, with regular follow-ups to monitor both dermatological healing and psychological improvement 1.