Self-Induced (Factitious) Injury
Although this patient has been treated by several health care providers for this expanding lesion on his scalp, nothing has worked. The pathology is clearly outside the “normal” realm. What’s going on?
A 60-year-old man presents with a 11/2-year history of an expanding lesion on the scalp. He has seen several other health care providers, none of whom have been able to provide any effective therapy.
Key point: This pathology is clearly outside the “normal” realm. A biopsy should been done to rule out extensive non-melanoma skin cancer and cultures should be obtained to identify infectious pathogens that are amenable to antimicrobial intervention. If the foregoing diagnostic maneuvers are unproductive, then it is important to remember that self-induced (factitious) disease may be responsible.
Treatment: The patient needs immediate attention by a qualified mental health professional to address psychological issues underlying this type of self-mutilation.
Note: After extensive counseling, the patient admitted that he was using a blunt letter opener to create and expand the skin lesion. He was extremely stressed at his workplace and was fearful of being fired.
Lebrikizumab Demonstrates Efficacy, Safety in Patients With Skin of Color With AD
June 11th 2025RAD 2025. Lebrikizumab improved skin clearance, itch, and pigmentation in patients with skin of color and atopic dermatitis, with strong safety data through 24 weeks, according to late-breaking data.
