CLINICAL PRESENTATIONA 44-year-old lady came to a dermatology clinic due to an asymptomatic, hyperpigmented plaque on her right thigh since 4 months ago. On physical exam, hypertrichosis on the lesion was notable (Figure 1). Rubbing the lesion resulted in erythema and edema of the lesion. She had no systemic disease and her family history was unremarkable.

A patient in her 20s was referred to us for psychological assessment due to her depression and suicide attempts. She mentioned being anorgasmic except when diapered and emphasized her erotic preference for diapers. Her childhood included maternal deprivation in an impecunious family headed by an irritable physically disabled father on social assistance. Given the maternal deprivation in childho...