title: Dermatitis artefacta in a vulnerable adult with a dissociative state.
abstract: Dermatitis artefacta (DA), a factitious skin disorder, often occurs as a response to traumatic life events or as a factitious behaviour, which may result in secondary gain. It can be difficult to get patients to engage with health services, and they seldom admit to causing the lesions themselves. The possibility of DA lesions occurring in dissociative states is less well known. We present a case of DA diagnosed in a vulnerable adult, who we believe caused the lesions during periods of dissociation. We discuss the way in which the concept of dissociation can provide an acceptable way of discussing the behaviour with patients and initiating psychological therapy.
authors.affiliation: Department of Dermatology, Barts Health NHS Trust, Royal London Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Ahmed
authors.forename: A
authors.initials: A
authors.lastname: Bewley
authors.forename: R
authors.initials: R
authors.lastname: Taylor
mesh_terms: D000328:Adult; D003872:Dermatitis / Q000209:etiology*; D004213:Dissociative Disorders / Q000150:complications*; D005162:Factitious Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007859:Learning Disabilities; D035862:Vulnerable Populations