A Strange Dermatitis in a Young Boy

Abstract

A 10-years-old Caucasian boy came to our attention for five lesions suddenly appeared, localized to the abdomen and thorax and appearing as red-brownish round macules with bullous or erosive area; only one presented with figurate shape. The child had no mucosal involvement, fever or itching and Nikolsky’s sign was negative. Dermatoscopic examination of the figurate lesion showed an erythematous border, red-brownish reticule and a small ulcerated area. He was treated with systemic Amoxicilline+Clavulanic acid and topical Ozenoxacin with significant improving after seven days. In the suspect of Dermatitis Artefacta, we decided to follow up the child. After one month, the child presented with a single erythematous rectangular lesion on his right clavicular region which had suddenly appeared. At examination, the lesion showed sharp margins, brown upper area and red-pink ulcerate lower area. Dermoscopic examination showed dotted and polymorphic vessels and a small ulcerated area, both present in the red-pink area.The diagnosis of Dermatitis Artefacta, induced by application of a warm object, was made. The patient was referred to the psychiatrist. Dermatitis Artefacta is a psychocutaneous disorder, patients create lesions in skin, hair, nail or mucosae to attract attention or satisfy a psychological need. It is rare in children and it is mostly observed in late adolescence to early adult life.KeywordsDermatite artefactaDematitis factitiaPathomimiaPsychocutaneous disorder