[ Une dermatose factice révélant un état dépressif ]
Volume 27, Issue 1, October 2016, Pages 191–195
Nomtondo Amina Ouédraogo1, Muriel Sidnoma Ouédraogo2, Gilbert Patrice Tapsoba3, Desiré Nanema4, and Fagnima Traoré5
1 Department of Dermatology, University of Ouaga I Joseph Ki-Zerbo, Raoul Follereau Center, Ouagadougou, Burkina faso
2 2Department of Dermatology, University of Ouaga I Joseph Ki-Zerbo, University Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso
3 Department of Dermatology, University of Ouaga I Joseph Ki-Zerbo, University Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso
4 Department of Psychiatry, University of Ouaga I Joseph Ki-Zerbo, University Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso
5 Department of Dermatology, Regional Hospital of Ouahigouya, Ouahigouya, Burkina Faso
Original language: French
Copyright © 2016 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
We report the case of a 27-year-old lady with psychiatric history, presented to dermatological consultation with 6 years, ambiguous history of recurrent skin ulcerations on her members, abdomen, chest and face, the cause of which she could not explain. Examination revealed different age lesions: erosive lesions of one to two centimeters, with net borders coexisting with crusted lesions and scarring hyper pigmented lesions situated on accessible parts of the body. No general signs accompanied these lesions and laboratory testing was normal. The diagnosis of dermatitis artefacta was raised, motivating a deepening interrogation that revealed psychosocial and interpersonal difficulties. Abandoned by her husband, who had married a second wife for six years (date of appearance of lesions). She was also accused to be responsible of repeated miscarriages of the second wife, and then repudiated without her 3 children who are abused by the second wife. Her psychiatric evaluation revealed a severe depression without psychotic symptoms. The recommended psychiatric treatment (psychotherapy and antidepressant medication) could not be conducted because she had broken up the medical following.
Author Keywords: dermatitis artefacta, self-inflicted injury, cutaneous artifactual disease, psychocutaneous, depression, psychomsomatic.
Volume 27, Issue 1, October 2016, Pages 191–195
Nomtondo Amina Ouédraogo1, Muriel Sidnoma Ouédraogo2, Gilbert Patrice Tapsoba3, Desiré Nanema4, and Fagnima Traoré5
1 Department of Dermatology, University of Ouaga I Joseph Ki-Zerbo, Raoul Follereau Center, Ouagadougou, Burkina faso
2 2Department of Dermatology, University of Ouaga I Joseph Ki-Zerbo, University Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso
3 Department of Dermatology, University of Ouaga I Joseph Ki-Zerbo, University Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso
4 Department of Psychiatry, University of Ouaga I Joseph Ki-Zerbo, University Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso
5 Department of Dermatology, Regional Hospital of Ouahigouya, Ouahigouya, Burkina Faso
Original language: French
Copyright © 2016 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
We report the case of a 27-year-old lady with psychiatric history, presented to dermatological consultation with 6 years, ambiguous history of recurrent skin ulcerations on her members, abdomen, chest and face, the cause of which she could not explain. Examination revealed different age lesions: erosive lesions of one to two centimeters, with net borders coexisting with crusted lesions and scarring hyper pigmented lesions situated on accessible parts of the body. No general signs accompanied these lesions and laboratory testing was normal. The diagnosis of dermatitis artefacta was raised, motivating a deepening interrogation that revealed psychosocial and interpersonal difficulties. Abandoned by her husband, who had married a second wife for six years (date of appearance of lesions). She was also accused to be responsible of repeated miscarriages of the second wife, and then repudiated without her 3 children who are abused by the second wife. Her psychiatric evaluation revealed a severe depression without psychotic symptoms. The recommended psychiatric treatment (psychotherapy and antidepressant medication) could not be conducted because she had broken up the medical following.
Author Keywords: dermatitis artefacta, self-inflicted injury, cutaneous artifactual disease, psychocutaneous, depression, psychomsomatic.
Abstract: (french)
Nous rapportons l’observation d’une jeune dame âgée de 27 ans, sans antécédent psychiatrique connu, ayant consulté en dermatologie pour des exulcérations cutanées évoluant depuis 6 ans dont l’histoire de la maladie ambiguë, imprécise était émaillé d’une errance diagnostic et thérapeutique. L’examen dermatologique notait des lésions d’âges différents : lésions exulcérées, érosives ovalaires variant de un à deux centimètres de grand axe, bien limitées, aux bordures nettes coexistant avec les lésions exulcero-croûteuses et des lésions cicatricielles hyperpigmentées siégeant sur les parties accessibles du corps : les membres supérieures, les membres inférieures, l’abdomen, le haut de la poitrine ainsi que le visage. Ces lésions n’étaient accompagnées d’aucun signe général et les examens paracliniques étaient normaux. Le diagnostic d’une pathomimie cutanée a été évoqué, motivant un approfondissement de l’interrogatoire. Celui-ci révéla des difficultés psychosociales et interpersonnelles. Elle était délaissée, par son mari, qui avait épousé une seconde femme depuis six ans (date d’apparition des lésions). Elle serait en outre accusée, d’être à l’origine des fausses couches répétées de sa co-épouse, puis répudiée sans ses enfants qui seraient maltraités par celle-ci. L’évaluation psychiatrique de la patiente a conclu à une dépression sévère sans symptômes psychotiques. La prise en charge psychiatrique préconisée (psychothérapie et traitement antidépresseur) n’a pu être menée, la patiente ayant rompu le suivi médical.
Author Keywords: pathomimie cutanée, automutilation, dermatose factice, psychocutané, dépression, psychosomatique.
How to Cite this Article
Nomtondo Amina Ouédraogo, Muriel Sidnoma Ouédraogo, Gilbert Patrice Tapsoba, Desiré Nanema, and Fagnima Traoré, “Artefacta dermatitis revealing depression,” International Journal of Innovation and Scientific Research, vol. 27, no. 1, pp. 191–195, October 2016.
