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In their initial report of dermatitis dysmenorrhœica symmetrica, Matzenauer and Polland1 detailed the measures they took to prevent malingering. They applied impermeable dressings. They kept their patients under constant surveillance. They covered developing lesions with watch glasses to observe their evolution undisturbed. Certain features of the disease strongly suggested factitia. There was also an inherent bias in the male-dominated medical community that women’s complaints were often hysterical. In the case of a condition so intimately associated with female problems like dysmenorrhea, this prejudice was even stronger.
Bernhardt M. Dermatitis Dysmenorrhœica Symmetrica. JAMA Dermatol. 2014;150(10):1043. doi:10.1001/jamadermatol.2014.374