title: Made up by makeup--A case report about an exceptional kind of self-inflicted "injuries".
abstract: BACKGROUND
  Self-inflicted injuries are a known, but challenging topic in the healthcare sector and the judicial system. Therefore, differentiation of these injuries from a third-party-interference is crucial in the field of forensic medicine. However, self-painted injuries with makeup, which entail misleading of medical staff and the administration of justice, have apparently not been described in the literature so far.
  
  
  METHODS
  A case of a rare kind of victim role staging in a 26-year-old Caucasian woman in the field of forensic medicine is presented. She supposedly had been robbed and harmed by two unknown men. The forensic examination revealed subjective symptoms and objective findings, such as skin discolorations appearing as fresh bruises. However, a closer look revealed makeup. After removal, no injuries were seen.
  
  
  CONCLUSIONS
  Awareness of the existence of exceptional cases of victim role staging is essential in the daily routine of healthcare, judicial and forensic professionals. Therefore, a questioning attitude within the physical examination as well as proper assessment of objective findings is crucial. Furthermore, the importance of an interdisciplinary approach of possible factitious disorders is demonstrated. The sensitization may exclude a third-party-interference, prevent damages to the health care system, avoid misleading of the administration of justice, and, therefore, reduce socioeconomic costs. Moreover, the recognition may enable adequate interventions and provide patients with professional help.
authors.affiliation: Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine (ZIFM), University of Zurich, Winterthurerstrasse 190/52, 8057 Zürich, Switzerland. Electronic address: sabrina.mauf@irm.uzh.ch.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Mauf
authors.affiliation: Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine (ZIFM), University of Zurich, Winterthurerstrasse 190/52, 8057 Zürich, Switzerland.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Martinez
authors.affiliation: Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine (ZIFM), University of Zurich, Winterthurerstrasse 190/52, 8057 Zürich, Switzerland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
authors.affiliation: Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine (ZIFM), University of Zurich, Winterthurerstrasse 190/52, 8057 Zürich, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Bartsch
mesh_terms: D000328:Adult; D003358:Cosmetics; D008192:Deception; D005162:Factitious Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D014947:Wounds and Injuries
chemical_list: D003358:Cosmetics
keywords: Clinical forensic medicine; Crime staging; Factitious disorder; Questioning physical examination; Staging