What are the other Names for this Condition? (Also known as/Synonyms)

• DA (Dermatitis Artefacta)
• Factitial Dermatitis

What is Dermatitis Artefacta? (Definition/Background Information)

• Dermatitis Artefacta (DA) is an uncommon and self-inflicted skin condition that develops in individuals who unconsciously injure their skin, such as by picking at their skin, sometimes with instruments. Due to this, the skin presentations can vary from one individual to another
• It is described as a mental health issue where the individual maims or injures themselves seeking an unconscious emotional (stress) release. Dermatitis Artefacta may also be an attention-seeking habit of the individual
• A timely management of the underlying mental health condition can help individuals with Dermatitis Artefacta. The overall prognosis is dependent on the severity of the underlying psychological condition, but is generally favorable with adequate management

Who gets Dermatitis Artefacta? (Age and Sex Distribution)

• Dermatitis Artefacta are generally observed in teens and young adults
• Both males and females are affected, but a higher incidence is reported among females
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Dermatitis Artefacta? (Predisposing Factors)

The risk factors for Dermatitis Artefacta include:

• Individuals with psychological or mental health issues
• Individuals who seek constant attention
• Emotionally immature men and women

Rarely, as a fraudulent means for claiming medical or other insurance. In these cases, it would be a form of malingering, and would be done consciously and deliberately.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Dermatitis Artefacta? (Etiology)

Dermatitis Artefacta is a form of self-inflicted skin injury caused by psychological issues of the individual. It may be described as mental health disorder in which the individual injures their skin in order to satisfy their unconscious emotional or psychological needs.

What are the Signs and Symptoms of Dermatitis Artefacta?

The signs and symptoms of Dermatitis Artefacta may widely vary from one individual to another. It may be mild or severe and affect any part of the body. There may be no single recognizable pattern or conformity to known skin infections/disorders. Many individuals are known to deny that their wounds are self-inflicted.

The signs and symptoms may include:

• Presence of irregularly shaped lesions anywhere in the body; some patterns may be linear or geometric
• The lesions may be in the form of red inflamed patches, blisters, cuts and nicks, chemical burns, or scarred skin
• The lesions appear within the range/reach of one’s hand movements
• The skin injury may correlate to the instruments/objects and the method used to harm oneself. Such objects may include one’s nails, writing instruments, pointed or blunt objects, heat, corrosive chemicals, etc.
• The skin area around the lesions usually appear normal
• There is often no gradual onset of the lesions; they present an acute onset (such as overnight)

Occasionally, it is not possible to identify if the skin lesions are part of a skin disease/disorder or are self-inflicted. It is important to exclude a primary skin disease before making the diagnosis of Dermatitis Artefacta

How is Dermatitis Artefacta Diagnosed?

A diagnosis of Dermatitis Artefacta may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation
• Psychological evaluation
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy, if necessary: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Dermatitis Artefacta?

The possible complications due to Dermatitis Artefacta include:

• Complications that arise from the underlying psychological condition
• Superimposed bacterial and fungal skin infections
• Recurrence of the condition
• Treatment complications

How is Dermatitis Artefacta Treated?

The treatment measures for Dermatitis Artefacta involve treating the underlying psychological/mental health disorder and treating the skin condition.

The treatments may include:

• Psychotherapy: It is the main method of therapy with the goal of helping the affected individual become more independent
• Medications can be used to help treat anxiety or depression, if necessary
• Symptomatic treatment of the lesions, as assessed by the healthcare provider

Regular follow up visits with the healthcare provider is important and recommended.

How can Dermatitis Artefacta be Prevented?

It may not be able to prevent Dermatitis Artefacta; however, seeking an early treatment for the underlying psychological condition may help reduce the risk for self-injury.

What is the Prognosis of Dermatitis Artefacta? (Outcomes/Resolutions)

The prognosis of Dermatitis Artefacta is dependent on the underlying causative (mental health) condition. Nevertheless, with adequate treatment the prognosis may be generally improved.

Additional and Relevant Useful Information for Dermatitis Artefacta:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/