Artefacta皮炎:诊断和治疗实用指南。

Julio Torales, Karina Malvido, María Alejandra Vázquez, Iván Barrios, José Almirón-Santacruz, Rodrigo Navarro, Marcelo O'higgins, Gabriel Casas, João Mauricio Castaldelli-Maia, Antonio Ventriglio, Israel González-Urbieta
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摘要

人工皮炎(DA)是一种基于患者行为模式的心理皮肤病,其特征是故意在自己的皮肤上产生皮肤损伤。临床表现可能变化很大。DA患者很少寻求心理支持或精神咨询。更多的时候,他们会向初级保健医生或皮肤科医生寻求帮助。这篇综述文章旨在为AD及其影响患者的诊断和管理提供实用指南。使用PubMed和Google Scholar电子在线数据库进行了广泛的文献搜索,关键词为“人工皮炎”、“诊断”、“管理”和“心理皮肤病学”。搜索仅限于英语和西班牙语文章,并辅以主题书籍和书籍章节。DA可发生在各种临床表现中,医生应怀疑有精神病史或广泛使用医疗服务的患者存在DA。DA治疗的最终目标可能是向心理健康服务机构进行适当的转诊。然而,即使获得了成功的心理健康转诊,预后也很差,康复率很低。一种有用的方法可能包括建议心理健康提供者可以帮助解决病变产生的焦虑和痛苦:在这种情况下,在获得患者的知情同意后,与心理健康提供者讨论这一点至关重要。考虑到促进患者坚持治疗的困难,DA治疗的理想环境是心理皮肤科诊所,在那里皮肤科和心理干预可以无缝整合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dermatitis Artefacta: A Practical Guide for Diagnosis and Management.

Dermatitis artefacta (DA) is a psycho-dermatologic condition based on patients' behavioral patterns, characterized by an intentional production of cutaneous lesions on their own skin. The clinical presentation can be highly variable. Patients with DA seldom seek psychological support or psychiatric consultation. More often, they seek help from their primary care physician or dermatologist. This review article aims to provide a practical guide for the diagnosis and management of AD and affected patients. A broad literature search was performed using the PubMed and Google Scholar electronic online databases, using key words "dermatitis artefacta", "diagnosis", "management", and "psychodermatology". The search was limited to English and Spanish language articles and was supplemented with themed books and book chapters. DA can occur in a variety of clinical presentations, and physicians should suspect DA in patients with a history of psychiatric disorders or extensive use of healthcare services. The ultimate goal of DA treatment may be a proper referral to mental health services. However, the prognosis is poor even when successful mental health referrals are achieved, with low recovery rates. A useful approach may include the suggestion that a mental health provider can help with the anxiety and the distress generated by the lesions: in this case in this case it will be crucial to discuss this with the mental health provider after obtaining informed consent from the patient. Considering the difficulty in promoting patients' adherence to treatment, the ideal setting for DA treatment is a psycho-dermatologic clinic, where both dermatologic and psychological interventions can be seamlessly integrated.

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