Acne excoriata--look for allergy!
Acne excoriata (AE) is a frequent variant of self-inflicted skin conditions, which occurs predominantly in females. The condition seems to be almost always found in persons with psychological problems. Therapeutic approaches are often unsatisfying since this special group of patients typically does not recover with dermatological treatment. We report a 37-year-old female patient who had suffered for 5 years from AE. Exact history taking revealed that her manipulations were correlated with episodes of contact with bird products like feathers and eggs. The diagnosis of a bird egg syndrome could be proved by skin prick tests (ALK Abello, Denmark) as well as laboratory results (CAP FEIA, Pharmacia, Sweden), and consequent avoidance of handling bird products was the only but effective therapeutic measurement. In patients with suspected artefactual diseases, we strongly recommend to listen to the patients' complaints in order to make the correct diagnosis and not to overlook a potential stimulus.
Kränke
B
B
Department of Environmental Dermatology and Allergy, University of Graz, Austria. birger.kraenke@kfunigraz.ac.at
Brabek
E
E
Derhaschnig
J
J
Aberer
W
W
D000152:Acne Vulgaris / Q000175:diagnosis* / Q000209:etiology; D000328:Adult; D017449:Dermatitis, Allergic Contact / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011602:Psychophysiologic Disorders; D012652:Self Mutilation