Excerpt from The Practical Medicine Series, Vol. 9 of 10: Comprising Ten Volumes on the Year's Progress in Medicine and Surgery; Skin and Venereal Diseases, Miscellaneous Topics
Dermatitis Artefacta in a Hysteric is reported by Q. 0. Adamson.4 The patient, an attractive young woman, was not suspected by Adamson of hysteria. Her illness began with the unexplained appearance of patches of weeping eczema on the face. These continued to recur on the cheeks, forehead, neck, arms, and later thighs and legs despite treatment and covering with dressing. The crop never failed for a year, the condition being some times better, sometimes worse. In the initial stage there was an erythemous ﬂush which rapidly became moist, suppurated and healed with a crust. The eruption was often square or linear, sometimes round. A dermatol ogist consulted pronounced the case one of dermatitis herpetiformis. The patient went to a specialist without results. Another dermatologist regarded it as a case of dermatitis artefacta. The parents were skeptical; watch ing by a nurse failed. The patient was removed at length to a nursing home. Here three days after admission, a movement under the bedclothes led to the detection of the lady's hand holding most unsuspiciously a handkerchief, but in the handkerchief was a small ragged piece of pumice-stone! Thereupon this protracted dermatosis came quickly to a complete end. The patient later feigned hemoptysis and bowel obstruction, and was detected.
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