title: Factitious Ulcer Misdiagnosed as Pyoderma Gangrenosum.
abstract: Dermatitis artefacta may represent a real challenge for the clinician. As the patient does not admit self-inflicting the lesions, misdiagnosis with other diseases, such as pyoderma gangrenosum, is common. Consequently, these patients normally go through unnecessary tests and receive potentially harmful treatments as clinicians determine their diagnosis. The authors present the case of a recurrent factitious abdominal ulcer that was initially diagnosed and treated as pyoderma gangrenosum. This report focuses on the necessity of suspecting dermatitis artefacta when morphology, history, and treatment failures are difficult to explain. It is essential to establish a supportive and confident approach and avoid initial confrontation. In-patient treatment may be useful and long-term followup may prevent recurrences.
authors.affiliation: Hospital Infanta Leonor, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Conde Montero
authors.affiliation: Hospital Infanta Leonor, Madrid, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Sánchez-Albisua
authors.affiliation: Centro de Especialidades Vicente Soldevilla, Hospital Virgen de la Torre, Madrid, Spain.
authors.forename: Soledad
authors.initials: S
authors.lastname: Guisado
authors.affiliation: Hospital Infanta Leonor, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Ángeles Martín-Díaz
authors.affiliation: Hospital Infanta Leonor, Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Balbín-Carrero
authors.affiliation: Hospital Infanta Leonor, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Valdivelso-Ramos
authors.affiliation: Hospital Infanta Leonor, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: de la Cueva Dobao
mesh_terms: D003951:Diagnostic Errors; D005162:Factitious Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000175:diagnosis*; D012883:Skin Ulcer / Q000175:diagnosis*