ABSTRACT
Factitious disorders in dermatology are varied and complex. These self-inflicted diseases span diagnostic categories and vary in clinical presentations. Among the spectrum of these disorders are dermatitis artefacta and malingering, both of which can manifest as ulcers. The difference between dermatitis artefacta and malingering lies in the intent of the patient. In dermatitis artefacta, however, lesions are produced either consciously or unconsciously for purposes of satisfying a psychological need of which he or she is not aware (1–3). This is in contrast to the malingerer, who consciously produces self-inflicted lesions for an external secondary gain such as money, getting out of work, obtaining privileges, or narcotics (1). Although the differential diagnosis for ulcers is extensive, the patient history of the ulcers and the clinical features of the lesions can provide clues in the diagnosis of factitial ulcers.
