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April 1987

Recurrent Herpes Simplex Infection Masquerading as Dermatitis Artefacta

Author Affiliations

Department of Dermatology; Department of Pathology Royal Hallamshire Hospital Sheffield S10 2JF, England

Arch Dermatol. 1987;123(4):435-436. doi:10.1001/archderm.1987.01660280035017

To the Editor.—  Dermatitis artefacta is a skin disorder in which, by definition, the lesions are entirely factitial in origin. The psychological motivation of patients may be obvious, such as in malingerers, but more commonly is complex, and indeed many patients appear to have otherwise fully integrated personalities. In some patients, the interface between genuinely pruritic skin diseases and dermatitis artefacta or neurotic excoriations becomes blurred. Where the lesions produced are sufficiently bizarre, or the methods used to produce them sufficiently aggressive, such as caustic liquids, the condition may be easy to recognize. Where more subtle methods are used, such as the fingernail, the condition may be unrecognized for years, and patients may be subjected to many expensive investigations. Nevertheless, while retaining a high index of suspicion for dermatitis artefacta, it clearly remains essential to exclude organic conditions before making this diagnosis.We report a female patient whose diagnosis of

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