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Factitious dermatitis: A retrospective study of 28 patients

Abstract:

Introduction: Factitious dermatitis (FD) is a psycho-cutaneous disorder in which patients present with self-inflicted lesions to satisfy a psychological need, of which they are not usually aware. Methods: A retrospective, descriptive and observational study of adult and paediatric patients with the clinical diagnosis of FD was carried out over a period of 15 years (1 January 2001 to 31 December 2015). From the sample obtained, the following clinical variables were collected: age on presentation, gender, time of follow-up, form of presentation, location, and the morphology of the lesions. Results: A total of 28 patients were selected, of which 23 (82%) were women, and eight (28%) were paediatric patients. The mean age was 32.6 years (8 to 78 years). Erosions were present in 9 (32%) patients, ulcers in 7 (25%) patients, purpuric lesions in 7 patients, and erythematous lesions in another 7 patients. A note was also made of blisters, scabs, panniculitis type nodules, and excoriations. Only 1 (3.5%) patient had eczematous lesions. The most frequent locations were the lower limbs (11 patients, 39%), followed by the face (9 patients, 32%), and the upper limbs (7 patients, 25%). Other affected locations were abdominal region in 3 (10%) patients, as well as the breast and the trunk in 2 patients, and the genitals in 1 patient. Conclusions: FD is an uncommon psycho-dermatological disorder with a clear gender predominance (female-to-male ratio of 8:1). It affects visible areas of the body and usually occurs in the form of destructive lesions