Pathomimia: From diagnostic errors to interdisciplinary interaction

According to the accumulated data, concomitant mental disorders are detected in a significant proportion of patients who initially seek medical care in dermatovenereological institutions. Psychodermatological disorders are a complex group of pathologies, the diagnosis and treatment of which are associated with the need to integrate knowledge from different areas of medicine. Skin symptoms of these diseases can imitate various pathologies, which prolongs the diagnostic search, contributes to the chronicity of the disease and deterioration in the quality of life of patients. An important aspect of treatment is an integrated approach, including dermatological and psychopharmacological therapy. Particular difficulties arise when managing patients with pathomimia (artifactual or artificial dermatitis) – a psychological disorder that is accompanied by self-harming behavior aimed at traumatizing the skin, mucous membranes, hair or nails. Patients with pathomimia conceal or do not realize the autodestructive nature of the rash, which is often accompanied by a refusal to consult a psychiatrist due to embarrassment or doubts about its necessity. Such behavior leads to an increase in the number of doctors involved by the patient in the diagnostic process and the volume of unjustified examinations, while patients often provide specialists with false anamnestic data. The article describes our own clinical observations of patients with pathomimia who had errors in verifying the disease. An analysis of the features of the anamnesis, differential diagnostic criteria and therapeutic tactics is presented. Attention is focused on the need to include this pathology in the list of differential diagnoses at the initial appointment. The importance of interdisciplinary interaction of doctors in order to form an effective strategy for treating patients with psychodermatological pathology is noted.