Dermatitis artefacta in soldiers

• Published in: Military medicine 2006-06, Vol.171 (6), p.497-499
• Main Authors: Cohen, Arnon D, Vardy, Daniel A
• Format: Article
• Language: English
• Subjects: Abdomen; Adrenal Cortex Hormones - therapeutic use; Adult; Antibiotics; Dermatitis; Dermatitis, Occupational - diagnosis; Dermatitis, Occupational - drug therapy; Dermatitis, Occupational - psychology; Disease; Exanthema - diagnosis; Factitious Disorders - diagnosis; Factitious Disorders - psychology; Female; Fever; Histamine H1 Antagonists - therapeutic use; Humans; Illnesses; Israel; Male; Malingering; Military Medicine; Military Personnel; Military service; Morphology; Patients; Prospective Studies; Pruritus - diagnosis; Risk Assessment; Risk Factors; Sick leave; Skin; Steroids
• ISSN: 0026-4075; 1930-613X
• DOI: 10.7205/MILMED.171.6.497

Dermatitis artifacta is not an uncommon disease in military settings. Soldiers may intentionally produce skin lesions to achieve sick leave from military duties. The aim of this work was to describe a series of soldiers with dermatitis artifacta. A prospective study was conducted among soldiers of the Israel Defense Force. Fourteen soldiers from the Israel Defense Force were included in the study. There were 13 men and one woman. The ages of the patients ranged between 19 and 26 years. For all patients, dermatitis artifacta was characterized by the acute appearance of a pruritic rash located on readily accessible areas of the limbs and abdomen. The rash was associated with systemic symptoms for 12 (85.7%) of 14 patients. None of the patients admitted to intentionally inflicting the skin lesions. The rash consisted of erythematous patches with numerous papules and pustules arranged in a linear pattern. All patients were treated with topical corticosteroids, four patients were treated with antibiotics, and three patients were treated with systemic corticosteroids. For all patients, the eruption resolved completely within 1 to 3 weeks. In the context of soldiers standing to gain sick leave by assuming the sick role, dermatitis artifacta can be reliably diagnosed by noting the characteristic location and morphological features of the skin lesions.