Dermatitis simulata as a clinical presentation for an underlying Munchausen syndrome: A case report

Munchausen syndrome, also known as factitious disorder imposed on self, is a psychiatric disorder involving various types of skin injuries, as the skin is a visible organ that can be easily observed. On the other hand, dermatitis simulata refers to conditions in which individuals only simulate and mimic skin diseases using external disguises without causing significant damage to the skin. The present study reports a rare case of dermatitis simulata in a young female, as a clinical presentation of Munchausen syndrome. An 18-year-old female patient had persistent red skin lesions around her eyes for 6 months. Despite multiple specialist visits and treatments, no improvement was observed. The lesions were determined to be caused by makeup, which was successfully cleaned with alcohol. A psychiatric evaluation revealed no extraordinary perceptual abnormalities apart from some concerns that she will lose her sight as no one could diagnose her condition. Patient education, reassurance and consistent care were crucial for successful treatment. Munchausen syndrome is a severe factitious disorder characterized by dramatic and untruthful illness stories. It is more common among females, individuals in early adulthood and in those with underlying psychiatric issues or stress. Patients often present with neurological and abdominal complaints, while dermatological manifestations are rare. Munchausen syndrome can be presented as dermatitis simulata that can be manifested by creating red skin lesions using makeup to satisfy psychological demands. Key words: dermatitis simulata, Munchausen syndrome, psychocu-taneous disorder, dermatitis artefacta, makeup