Conflicts of interest: None.
Artefactual skin lesions in children and adolescents: review of the literature and two cases of factitious purpura
Version of Record online: 16 APR 2014
© 2014 The International Society of Dermatology
International Journal of Dermatology
Volume 54, Issue 1, pages e27–e32, January 2015
How to Cite
Ring, H. C., Miller, I. M., Benfeldt, E. and Jemec, G. B.E. (2015), Artefactual skin lesions in children and adolescents: review of the literature and two cases of factitious purpura. International Journal of Dermatology, 54: e27–e32. doi: 10.1111/ijd.12493
- Issue online: 22 DEC 2014
- Version of Record online: 16 APR 2014
Self harm is a great diagnostic and treatment challenge. In addition, psychocutaneous conditions are rare in the pediatric population and may therefore be misdiagnosed. Dermatitis artefacta is a psychocutaneous syndrome, which is a subgroup of the general spectrum of self-inflicted skin lesions. Dermatitis artefacta encompasses an array of different clinical manifestations, including purpura. Factitious purpura has rarely been reported in children.
Case report and review of the literature.
We describe two Caucasian patients (9-year-old boy and 10-year-old girl) with striking purpuric lesions diagnosed as factitious purpura. The clinical lesions were similar, but the underlying psychological problems differed significantly (depression and stress). The current state of knowledge of dermatitis artefacta in children and adolescents was reviewed.
The presence of purpura in children and adolescents typically causes extensive intervention programs due to the possible serious pathological consequences. The two cases demonstrate a need for a high degree of attention to psychological disturbances, lesional evolution, and distribution once the suspicion is established.