Factitious disorders in adults: two cases of unusual skin ulcers.

The factitious disorders (FDs) include a large group of dermatological conditions characterized by skin lesions that patients themselves self-inflict but deny their active participation. FDs usually represent a diagnostic challenge, and their therapeutic management is usually based on a multidisciplinary approach because most FRD patients also suffer from undiagnosed behavior and personality disorders. We report two cases of FD: one patient that was suffering from severe depression and induced third-degree chemical burns on his own lower limbs, and another patient affected by obsessive-compulsive disorder and anorexia nervosa that presented with deep self-inflicted ulcers on her face. Our multispecialist approach, based on close cooperation between dermatologists and psychiatrists, led to a significant improvement of clinical conditions in both cases. Dermatologists need to be aware that FDs are complex disorders and a multidisciplinary approach is usually recommended to control their clinical course.

General practitioners' accuracy in diagnosing skin cancers.

BACKGROUND: The incidence of both melanoma and nonmelanocytic skin cancers has risen dramatically during the past decades, skin cancer becoming an important public health concern. OBJECTIVE: The purpose of this study was to assess the ability of general practitioners (GPs) in the early diagnosis of skin cancers, their correct differential diagnosis of benign lesions and their accuracy in the choice of the treatment. METHODS: A multiple-choice questionnaire regarding 7 cases (with 4 figures) were sent to 625 GPs to evaluate their diagnostic abilities. CONCLUSIONS: The results indicate that many GPs are not confident in their ability to recognize the most common skin cancers, and knowledge deficiencies were identified.