The Munchausen’s Syndrome: A Diagnosis Not to Be Forgotten in Dermatology - Abstract
Munchausen’s syndrome refers to patients who injure their bodies and repeatedly request medical assistance due to these illnesses or factitious conditions. In the reported case, an 11-year-old girl was referred to the dermatology outpatient clinic, accompanied by her mother, who reported the appearance of red-pink spots on the skin, with a burning sensation, with one month of evolution. The patient has attended a pediatric emergency weekly, where intramuscular promethazine and intravenous corticosteroids were frequently prescribed, with reported improvement of the burning sensation. She was also seen at an allergy outpatient clinic, where she underwent contact examinations and was subjected to various dietary restrictions. On physical examination, red-pink spots were observed on the face, though sparing the mucous membranes. Some lesions were arranged in a linear pattern and pigment of the same color was observed in the hyponychium. Due to the weird clinical presentation, a gauze soaked in saline solution was rubbed in the cervical region and the pigmentation was removed. After 7 days, the patient returned without the stains and was referred to a psychiatrist. Inconsistent aspects of the lesions that were observed on physical examination, pointed to the correct diagnosis. Early identification of Munchausen’s syndrome helps to avoid iatrogenesis. In this paper we report a case of Munchausen Syndrome in a child, reviewing its main topics, and give awareness about the possible iatrogenesis induced when misdiagnosed.