Dermatitis Artefacta: A Study of 42 Patients with Management Considerations.

Background: Dermatitis artefacta (DA) is a primary psychiatric disorder in which patients self-inflict skin lesions to attract the attention of family members to release emotions or simply gain compensation. Studies involving patients with DA are difficult to conduct because patients typically move from one hospital to another. Moreover, very little has been written about its treatment, as most published series of cases have been presented without reporting the follow-up.

Objectives: To study the characteristics and therapeutic results in patients with dermatitis artefacta followed up at a university medical centre in Brazil.

Methods: We performed a retrospective study of patients with dermatitis artefacta at a dermatological university clinic. The medical records were reviewed to obtain personal data and treatment findings.

Results: Forty-two patients were included in this study. Twenty patients were treated with placebo pills plus topical treatments, 14 patients received no treatment, and four patients used only topical treatment. The follow-up period for these patients ranged from a single visit to 7 years. Psychiatric interviews were conducted without the presence of a dermatologist in only a few cases.

Conclusions: A dermatologist is a healthcare professional who should be prepared to diagnose and manage cases of DA, and referral to a psychiatrist is usually unsuccessful. The success of the treatment depends on how the doctor approaches the patient. The use of placebo pills may help some patients adhere to treatment and strengthen their therapeutic bonds.