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November 1980

Folie à Deux: Factitious Ulcers

Arch Dermatol. 1980;116(11):1303-1304. doi:10.1001/archderm.1980.01640350093024

Folie à deux is a psychotic disorder characterized by the sharing of a delusional pattern by two psychologically interrelated individuals. As first described in 1877 by Lasègue and Falret,1 the two affected persons are usually longtime, intimately linked individuals. One of the pair is aggressive and dominant, the other submissive and suggestible. The dominant person has a delusional, often persecutory, psychosis, and the submissive partner adopts the delusional ideas. When the two affected individuals are separated, the delusions often persist in the primary partner and resolve in the secondary partner. Several excellent reviews of folie à deux have been published.2,3 Gralnick3 implied that the clue to understanding mental illness lies in the intertwining relationships of folie à deux. We present an example of folie à deux characterized by factitious ulcers.

Report of a Case  In 1970, twin 82-year-old sisters had almost identical recurrent ulcerations of the lower

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