Psychiatric comorbidities and treatment strategies in dermatitis artefacta: a narrative review

Dermatitis artefacta (DA) is a rare psychodermatologic condition characterized by self-inflicted skin lesions that patients typically deny causing. These lesions often present with atypical morphologies and distributions, which can delay diagnosis and complicate management. DA is strongly associated with underlying psychiatric conditions such as depression, anxiety, trauma-related disorders, and personality disorders. Clinicians should adopt a non-confrontational, supportive approach to foster trust and improve patient engagement, as confrontational strategies may increase shame and reduce follow-up adherence. Optimizing management requires an integrated dermatologic and psychiatric treatment model, as addressing comorbid psychiatric conditions can reduce the severity of DA. Current therapeutic recommendations are primarily based on case reports, case studies, and expert opinion, as controlled studies in DA remain scarce. Consequently, psychotherapeutic and pharmacologic interventions such as CBT, AEBT, EMDR, SSRIs, and mood stabilizers may be considered as individualized treatment options based on the patient’s psychiatric presentation rather than established standards of care. Long-term management relies on consistent follow-up, empathetic communication, and individualized treatment planning.

Abstract from Crossref