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Giornale Italiano di Dermatologia e Venereologia 1999 April;134(2):99-113


language: Italian

Dermatitis artefacta

Angelini G., Bonamonte D.

Università degli Studi - Bari, II Clinica Dermatologica, Policlinico


Artefact or simulated diseases are self-inflicted complaints caused by various different means and for various different purposes. Simulation of disease can be motivated by illicit intent, to escape civil duties or prison sentence, for instance, or to exploit situations of a professional nature. In this case, the simulator is fully aware of his action and his intention. On the contrary, in the case of pathomimic artefact, the subject suffers from psychological problems. In this case, the intrinsic reason for the self-inflicted lesions is quite different: the subject aims to attract the attention of the people around him, and in particular of his general practitioner, or else is reacting to difficult or unfavourable environmental conditions by means of involuntary somatization at the level of the skin. Unconscious simulators of this type are prevalently females. Artefact skin diseases caused with illicit intent, aiming to gain various advantages, are true simulations, whereas lesions provoked unconsciously by subjects with psychological disturbances, without any venal intention, are described as pathomimic. Apart from these two groups, true malingering and pathomimic artefact, there is a third group of self-inflicted dermatoses, constituted by behavioural disorders involving some compulsory habits (neurotic excoriations, tics). The great majority of subjects suffering from the latter disturbances are quick to confess the urge to self-inflict lesions. Dermatitis artefacta can also be observed in children, both of unconscious and deliberate (non venal) type.This study examines the various clinical forms of dermatitis artefacta and the diagnostic criteria.

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