MALIGNANT CHANGE IN DERMATITIS ARTEFACTA

Dermatitis artefacta is a chronic skin lesion produced by self-trauma. Avoidance of further trauma, topical steroids and psychological thera py alt play a part in the treatment of such lesions. Unresolved lesion s may become large and disfiguring and subject to infection. We report a case of one such lesion in an elderly woman who persistently excori ated a cholecystectomy scar over 40 years. Malignant transformation oc curred in a manner analogous to the neoplastic change observed in othe r types of chronic ulcer (Marjolin's ulcer). The squamous cell carcino ma presented with widespread metastases from which the patient eventua lly died. Recent literature concerning Marjolin's ulcers is reviewed a nd it is noted that this is the first reported case of death caused by malignant change in dermatitis artefacta.