Artificial dermatitis and its complications: features of diagnosis and therapy

Abstract

The article highlights the problem of artificial dermatitis (pathomimia) as a manifestation of a mental disorder. A direct correlation is shown between the severity of mental illness and the severity of injuries inflicted on the skin. It is shown that it is necessary to manage such patients with the participation of a psychiatrist and a dermatologist. Positive results of treatment of infected skin lesions using Levomekol® ointment are presented.Materials and methods. We observed 19 patients, 7 women and 12 men. All patients, even with shallow, but extensive excoriations, Levomekol® ointment was prescribed under a bandage with a superficial additional fixation with a Band-Aid bandage in order to prevent self-removal of the bandage.Results.All 19 patients had epithelialization of existing erosions and healing (the beginning of scarring) of ulcers. The healing time of self-injuries was as follows, depending on the depth of the lesion: surface erosion and excoriation‑2 days, deep excoriation – 5 days, surface ulcers: on the upper extremities and neck – 9 days, on the lower extremities‑11 days.Conclusions. 1) Psychosomatic disorders, most often encoded by dermatologists under the heading ‘artificial dermatitis (ArD)’, are one of the pressing problems of modern medicine at the intersection of psychiatry and dermatology. 2) The severity and depth of destructive manifestations of ArD on the skin directly correlates with the severity of mental disorders. 3) With deep and multiple skin injuries, already at the level of impulsive disorders, there is a high probability of secondary infection. With ulcerative defects, such infection occurs inevitably. 4) Levomekol® ointment is a drug not only with a proven antimicrobial and regenerating effect, but also with a proven possibility of use in wounds with a pronounced exudative component, with excoriations of any depth. 5) When applying Levomekol® ointment on a large surface or on deep ulcers, the possibility of systemic effects should be taken into account, according to the instructions (such effects were not recorded in the presented study).