DERMATITIS ARTEFACTA - A GENERAL-REVIEW

The place of dermatitis artefacta among the self-inflicted skin condit ions remains to be precisely defined. Indeed, a rigorous and consensua l definition could influence the entire dermatological and psychologic al therapeutic approach. Dermatitis artefacta covers a range of condit ions of the body surface that are self-inflicted in a fully conscious manner. Patients hide their responsibility from the successive medical teams they consult. There is no precise rational motive for such beha vior. The skin condition is secondary to a behavioral disorder: in oth er words, the psychological problem is primary. The diagnosis of derma titis artefacta is always difficult, but should not be arrived at by a process of elimination. It is based on a comparative analysis of soma tic and dermatological features and psychological arguments. This make s close collaboration between all the members of the medical team esse ntial, and each must be persuaded that the skin condition is the expre ssion of hidden mental anguish. Dermatitis artefacta is one of the mos t difficult conditions to treat in the fields of dermatology and psych iatry. Dermatological care must be combined with a psychological appro ach. The latter will usually involve drug therapy for depression and p sychotherapy adapted to the particular personality of these patients.