Recurrent deep ulcers resembling rare cancers as a form of factitious disorder.

Factitious disorders are defined as acts of self-harm that directly or indirectly result in clinically-relevant injury. They are typically performed in secret and without direct intention of suicide (1, 2). The patient’s initial goal is hospital admission and receiving medical treatment to confirm the severity of their state (3). Current prevalence ranges of factitious disorders is between 0.05 and 2.0%, with women being 4–20-fold more likely to be affected than men (1, 4–8). Contemporary psychodermatology classifies these disorders as: 1) dermatoses of primary psychiatric genesis (emotional/psychiatric disorders); 2) dermatoses with a multifactiorial basis, of which the course is subject to psychiatric influences (psychosomatic disease); or 3) secondary psychiatric disorders due to serious or disfiguring dermatoses (somatopsychic disease) (9). Mood swings, anxiety, impulsive behavior and somatization disorders are common among patients with dermatitis artefacta (5, 10–12).