Abstract
Self-inflicted dermatoses are associated with personality disorders and psychoses, including monosymptomatic hypochondriacal psychosis (MHP), which is characterized by a delusion involving a particular hypochondriacal concern. We report an unusual case of MHP with severe mutilation of the skin complicated by a skull defect and brain abscess. The patient was a 66-year- old uneducated man who damaged his forehead repeatedly because he believed that a 'toxic root' in the forehead was the source of his general ailment. He admitted that the lesions were self-inflicted. There was no other evidence of psychosis or primary skin disease and MHP was diagnosed. Despite initial favourable response to pimozide, the patient was lost to follow-up for 4 years, during which he continued to damage his forehead and applied corrosive agents. He was then referred with a personality change and a 6 x 4 cm bony defect in the skull, complicated by herniation and abscess of the left frontal lobe. This case represents one of the most severe examples of self- mutilation ever reported. The differential diagnosis of dermatitis artefacta and the principles of treating MHP are discussed.
| Original language | English |
|---|---|
| Pages (from-to) | 299-302 |
| Number of pages | 4 |
| Journal | British Journal of Dermatology |
| Volume | 137 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1997 Jan 1 |
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All Science Journal Classification (ASJC) codes
- Dermatology
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Monosymptomatic hypochondriacal psychosis complicated by self-inflicted skin ulceration, skull defect and brain abscess. / Wang, C. K.; Lee, Yu-Yun.
In: British Journal of Dermatology, Vol. 137, No. 2, 01.01.1997, p. 299-302.Research output: Contribution to journal › Article
TY - JOUR
T1 - Monosymptomatic hypochondriacal psychosis complicated by self-inflicted skin ulceration, skull defect and brain abscess
AU - Wang, C. K.
AU - Lee, Yu-Yun
PY - 1997/1/1
Y1 - 1997/1/1
N2 - Self-inflicted dermatoses are associated with personality disorders and psychoses, including monosymptomatic hypochondriacal psychosis (MHP), which is characterized by a delusion involving a particular hypochondriacal concern. We report an unusual case of MHP with severe mutilation of the skin complicated by a skull defect and brain abscess. The patient was a 66-year- old uneducated man who damaged his forehead repeatedly because he believed that a 'toxic root' in the forehead was the source of his general ailment. He admitted that the lesions were self-inflicted. There was no other evidence of psychosis or primary skin disease and MHP was diagnosed. Despite initial favourable response to pimozide, the patient was lost to follow-up for 4 years, during which he continued to damage his forehead and applied corrosive agents. He was then referred with a personality change and a 6 x 4 cm bony defect in the skull, complicated by herniation and abscess of the left frontal lobe. This case represents one of the most severe examples of self- mutilation ever reported. The differential diagnosis of dermatitis artefacta and the principles of treating MHP are discussed.
AB - Self-inflicted dermatoses are associated with personality disorders and psychoses, including monosymptomatic hypochondriacal psychosis (MHP), which is characterized by a delusion involving a particular hypochondriacal concern. We report an unusual case of MHP with severe mutilation of the skin complicated by a skull defect and brain abscess. The patient was a 66-year- old uneducated man who damaged his forehead repeatedly because he believed that a 'toxic root' in the forehead was the source of his general ailment. He admitted that the lesions were self-inflicted. There was no other evidence of psychosis or primary skin disease and MHP was diagnosed. Despite initial favourable response to pimozide, the patient was lost to follow-up for 4 years, during which he continued to damage his forehead and applied corrosive agents. He was then referred with a personality change and a 6 x 4 cm bony defect in the skull, complicated by herniation and abscess of the left frontal lobe. This case represents one of the most severe examples of self- mutilation ever reported. The differential diagnosis of dermatitis artefacta and the principles of treating MHP are discussed.
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U2 - 10.1046/j.1365-2133.1997.18261917.x
DO - 10.1046/j.1365-2133.1997.18261917.x
M3 - Article
VL - 137
SP - 299
EP - 302
JO - British Journal of Dermatology
JF - British Journal of Dermatology
SN - 0007-0963
IS - 2
ER -