Selfinflicted skin lesions in practice case reports Anna
- Slides: 24
Self-inflicted skin lesions in practice - case reports Anna Zalewska-Janowska Psychodermatology Department Interfaculty Chair of Clinical Immunology and Microbiology, Medical University of Lodz, po. LAND
Presentation Outline General characteristics of self-inflicted skin lesions Selected diagnoses for self-inflicted skin lesions Clinical presentations – examples Take home massage
Self – inflicted skin lesions general characteristics • „hollow history” – patient resistance to fully describe • • • the evolution of skin lesions numerous professional consultations conscious/unconscious performance triggering/exacerbating actions areas accessible to manipulation bizarre morphology severity span
Self – inflicted skin diseases – selected diagnoses • Lichen simplex • Dermatitis artefacta • Neurotic excoriations • Acne excoriée • Münchausen syndrome • Malingering (disease simulation)
Dermatitis artefacta • Unconscious action (mostly); patients do not admit to manipulation • F: M = 3: 1 to 20: 1 • „cry for help” • borderline or paranoid personality
Neurotic excoriations • majority – patients admit to self-manipulation • mainly middle-aged single women • difficulties in problem verbalizing • vicious circle – itching-scratching
Acne excoriée • squeezing and picking the acne lesions under stress; sometimes lack of comedos • female predominance • mean age – 30 years; mainly face • co-existence – phobias, depression
Münchausen syndrome • dramatic presentation of symptoms, in the middle of the night • male predominance • aim – gaining the constant medical care („hospital dependence”) • psychopathic personality, antisocial behaviour
Malingering • totally conscious performance • aim – responsibility avoidance, financial gain, earlier pension • male predominance • borderline or paranoid personality
Take home message When skin lesions present bizarre morphology or recur „too often” despite professional treatment THINK about different goals of the patient and the doctor and ACT accordingly…
- Describing skin lesions
- Primary and secondary lesions of skin
- Difference between formal and informal reports
- Thin skin vs thick skin
- Thin skin vs thick skin
- Chapter 23 milady review questions
- Best case worst case average case
- Pie in the sky lesion
- Extrapyramidal tract function
- Premalignant lesions of esophagus
- Olneys lesions
- Reticulospinal tract
- Caries profunda definition
- Nature lésions
- Classification of white lesions of oral cavity
- Dont touch lesion
- Lesions of glossopharyngeal nerve
- Chronic hyperplastic candidiasis
- It projektov�� mana����r
- Scattered white matter lesions
- Daughter mother grandmother pancreatic lesions
- Periradicular disease
- Eye lesions
- Eye lesions
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