title: Facial ulcer treated with olanzapine.
abstract: A 69-year-old woman presented with a nonhealing ulcer on her right cheek. On histological examination of a biopsy, no evidence of granuloma formation or malignancy was found, and the overall picture was felt to be consistent with dermatitis artefacta (DA). The patient was referred to a joint psychodermatology clinic, where treatment with risperidone was started. However, at follow-up the ulcer remained unchanged, and treatment was changed to olanzapine 2.5 mg twice daily. Within 10 months, the large facial ulcer, which had been refractory to treatment for several years, had completely healed. Anxiolytics, antidepressants and low-dose antipsychotics have been shown to be helpful in the management of DA. Successful treatment with olanzapine has been described. The good clinical response to olanzapine may be attributed to its anti-impulsive effect, antihistaminic properties and low risk of parkinsonian side-effects.
authors.affiliation: Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, UK. clairelouiselowry@hotmail.com
authors.forename: C L
authors.initials: CL
authors.lastname: Lowry
authors.forename: A
authors.initials: A
authors.lastname: Bewley
authors.forename: R
authors.initials: R
authors.lastname: Taylor
mesh_terms: D000368:Aged; D001569:Benzodiazepines / Q000627:therapeutic use*; D018492:Dopamine Antagonists / Q000627:therapeutic use*; D057915:Drug Substitution; D005148:Facial Dermatoses / Q000188:drug therapy*; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D000077152:Olanzapine; D018967:Risperidone / Q000627:therapeutic use; D012883:Skin Ulcer / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D018492:Dopamine Antagonists; D006633:Histamine Antagonists; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine