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Peng Yue, Kaiyu Zhou, Yimin Hua, Jie Fang, Yifei Li
RATIONALE: Hemoptysis or hematemesis is a common clinical symptom in adults, but is unusually to be observed in children. Hemoptysis can occur with circulatory diseases, injuries, several types of systemic diseases, or systemic factors including factitious disorder (FD), which is difficult to be diagnosed. Here, we report a case of hemoptysis caused by FD to provide a diagnostic flow chart for such kind of disease. PATIENT CONCERNS: An 11-year-old female patient had a history of hemoptysis or hematemesis for 6 months and suffered with paroxysmal syncope for a month...
February 2019: Medicine (Baltimore)
Wen-Hao Pan, Xu-Dong Sun, Li-Mei Wu, Kai-Kai Yang, Ning Tang
Asphalt concrete has been widely used in road engineering as a surface material. Meanwhile, ultrasonic testing technology has also been developed rapidly. Aiming to evaluate the feasibility of the ultrasonic wave method, the present work reports a laboratory investigation on damage detection of asphalt concrete using piezo-ultrasonic wave technology. The gradation of AC-13 was selected and prepared based on the Marshall's design. The ultrasonic wave velocities of samples were tested with different environmental conditions firstly...
January 31, 2019: Materials
Marcello Menta Simonsen Nico, Alexandre Jack Dwan, Silvia Vanessa Lourenço
BACKGROUND: The terms exfoliative cheilitis, factitial cheilitis, and morsicatio labiorum are used to describe self-inflicted lesions of the lip. OBJECTIVE: Here we report and analyze clinical, pathological, and therapeutic data on 13 patients with a form of factitial cheilitis that we believe should be considered a separate entity. RESULTS: Eight patients were male and 5 patients were female. All patients reported pain and presented with crusts consisting of dried saliva and topical medications adherent to the surface of the lips...
January 17, 2019: Journal of Cutaneous Medicine and Surgery
Huda Al Ghadeer, Saleh Al Othaimeen, Mohammad Al Amry
Munchausen's Syndrome is a factitious disorder in which patients manipulate physicians through misrepresented signs and symptoms. The authors describe an 18-year-old woman with self-induced inoculation of ant's particles inside her conjunctival fornices of both eyes. The crushed particles was confirmed to be crushed ant's particles. Munchausen Syndrome can be seen with ophthalmic manifestations and should be considered in the differential diagnoses when ocular abnormalities cannot be explained. A sympathetic and supportive approach is therefore required and these patients should be urgently referred to a psychiatrist...
October 2018: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
S Rice, K O'Brien, M Chew, E Qudairat
Patients with factitious disorder typically present with signs or symptoms suggesting a medical problem, but which transpire to be self-induced or fabricated. Repeated investigations and treatments are often carried out to no avail before this possibility is considered. In this case, a 51-year-old female presented to the oral and maxillofacial surgery unit with toothache and a facial rash. Following admission to hospital a range of investigations were performed, and a tooth was extracted. Judicious attention by nursing staff led to the discovery that the patient had been applying make-up to mimic a skin rash...
December 21, 2018: British Dental Journal
Louis H Poppler, Susan E Mackinnon
Pain is a frequent cause of physician visits. Many physicians find these patients challenging because they often have complicated histories, emotional comorbidities, confusing examinations, difficult problems to fix, and the possibility of factitious complaints for attention or narcotic pain medications. As a result, many patients are lumped into the category of chronic, centralized pain and relegated to pain management. However, recent literature suggests that surgical management of carefully diagnosed generators of pain can greatly reduce patients' pain and narcotic requirements...
December 12, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Ashruta Patel, Gary Daniels
BACKGROUND: Factitious disorder causing hypoglycemia is a psychiatric condition in which patients deliberately use blood sugar lowering medications to cause severe symptoms for the purposes of hospitalization or other primary gains. CASE PRESENTATION: We report a case of factitious hypoglycemia in a 19-year-old foster care adolescent female who presented to the Emergency Department with recurrent hypoglycemic episodes, to the degree that the patient required large amounts of dextrose and further management by intensive care unit hospitalization...
December 11, 2018: BMC Emergency Medicine
Michael Joseph Lavery, Carolyn Stull, Iain McCaw, Rachel B Anolik
Dermatitis artefacta, also known as factitial dermatitis, is a condition whereby self-induced skin damage is the means used to satisfy a conscious or unconscious desire to assume the sick role. It is particularly common in women and in those with an underlying psychiatric diagnosis or external stress. The diagnosis is one of exclusion, and it is often difficult to confirm, with patients rarely admitting their role in the creation of their lesions. Treatment can be challenging, and management should adopt a multidisciplinary team approach composed of dermatologists and mental health professionals...
November 2018: Clinics in Dermatology
Christopher Bass, Derick T Wade
Although exaggeration or amplification of symptoms is common in all illness, deliberate deception is rare. In settings associated with litigation/disability evaluation, the rate of malingering may be as high as 30%, but its frequency in clinical practice is not known. We describe the main characteristics of deliberate deception (factitious disorders and malingering) and ways that neurologists might detect symptom exaggeration. The key to establishing that the extent or severity of reported symptoms does not truly represent their severity is to elicit inconsistencies in different domains, but it is not possible to determine whether the reports are intentionally inaccurate...
November 13, 2018: Practical Neurology
Joshua A David, William J Rifkin, Ernest S Chiu
OBJECTIVE: Despite the presence of self-inflicted wounds (SIWs) across all of medicine, our current understanding of SIWs in surgery is limited. Here, we detail the pertinent aspects of the history, diagnosis, decision making, and management of SIWs as they relate to the field of surgery. In addition, we present the first comprehensive review of SIWs across the surgical literature. SUMMARY BACKGROUND DATA: Self-inflicted wounds have been recognized for much of recorded human history and span a wide spectrum of patient behaviors, motivations, and underlying psychiatric illnesses...
October 31, 2018: Annals of Plastic Surgery
Mohamed El Amraoui, Badredine Hassam
Self-induced dermatoses are more and more frequent in adolescent substance abusers with adaptation problems. We here report a case of self-induced bullous lesions on the shoulder in an adolescent with major depression and suicidal ideations. The study involved a 22-year old man, who was a chronic smoker, an occasional user of cannabis and alchool with no particular past medical history, with divorced parents, in conflict with his father. He presented with bullous eruption on the left shoulder made of bubbles, post-bullous skin erosions and scabs on a healthy skin...
2018: Pan African Medical Journal
A Marzouki-Zerouali, A Schoeffler, A-L Liegeon, P Le Vaou, F Truchetet
BACKGROUND: Factitious disorders constitute a complex pathology for the dermatologist. Although a diagnosis is often indicated, it is difficult to confirm and treatment is complicated. Dermatitis artefacta is the somatic expression of an often serious psychiatric disorder consciously created by patients on their own cutaneous-mucosal surfaces but the motivation is unconscious and no secondary benefits are sought (in contrast to simulation). Pathomimicry represent a specific entity: the provocation of outbreaks of a known disease, triggered by voluntary exposure to a causative agent...
October 22, 2018: Annales de Dermatologie et de Vénéréologie
Lingzhan Miao, Peifang Wang, Jun Hou, Yu Yao, Zhilin Liu, Songqi Liu, Tengfei Li
Microplastics are frequently detected in freshwater environments, serving as a new factitious substrate for colonization of biofilm-forming microorganisms. Distinct microbial assemblages between microplastics and surrounding waters have been well documented; however, there is insufficient knowledge regarding biofilm colonization of plastic and non-plastic substrates, despite the fact that microbial communities generally aggregate on natural solid surfaces. In this study, the effects of substrate type on microbial communities were evaluated by incubation of biofilms on microplastic substrates (polyethylene and polypropylene) and natural substrates (cobblestone and wood) for 21 days under controlled conditions...
February 10, 2019: Science of the Total Environment
M P Pereira, C Zeidler, T Nau, S Bobko, A W M Evers, S Garcovich, M Gonçalo, J A Halvorsen, J Lambert, F J Legat, T Leslie, M Metz, L Misery, K Nordlind, A Reich, G Schneider, H Ständer, M Streit, J C Szepietowski, J Wallengren, E Weisshaar, S Ständer
BACKGROUND: Chronic prurigo (CPG) is a distinct disease characterized by chronic pruritus, history and/or signs of prolonged scratching and multiple pruriginous lesions. It may present with various clinical manifestations, including papules, nodules, plaques or umbilicated lesions. Some patients with chronic pruritus show pruriginous linear and scaring scratch lesions (LSSL) and it is unclear whether these lesions belong to the spectrum of CPG. OBJECTIVE: To achieve a consensus on the classification of pruriginous LSSL and establish criteria to differentiate them from similar appearing conditions of different nature...
October 5, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Alexandra J Sequeira, Michael G Fara, Ariane Lewis
Tissue plasminogen activator (tPA) is administered to patients with suspected ischemic stroke to improve blood flow to the brain In rare cases, patients present with complaints of stroke symptoms that appear to be non-organic due to malingering, factitious disorder, or conversion disorder (psychogenic stroke mimics). Deciding whether or not to administer tPA to these patients can be challenging. The risk of hemorrhage after administration of tPA is low, but not zero. The ethical principles of beneficence and nonmaleficence need to be weighed carefully in these situations...
2018: Journal of Clinical Ethics
Sarah Velsor, Richard Rogers
Practitioners and researchers have long been challenged with identifying deceptive response styles in forensic contexts, particularly when differentiating malingering from factitious presentations. The origins and the development of factitious disorders as a diagnostic classification are discussed, as well as the many challenges and limitations present with the current diagnostic conceptualization. As an alternative to a formal diagnosis, forensic practitioners may choose to consider most factitious psychological presentations (FPPs) as a dimensional construct that are classified like malingering as a V code...
September 17, 2018: Behavioral Sciences & the Law
Mario Diplomatico, Pierluigi Marzuillo, Daniela Capalbo, Michela Stanco, Rosaria Marotta, Stefano Guarino
: A 12-year-old boy, with intermittent abdominal pain from 3 years of age, presented with increased frequency of right lower quadrant pain (at least three episodes per week over the past six months) and pain during micturition affecting school attendance. His family history included referred urolithiasis. An abdominal ultrasound performed 1 year before our visit showed a small stone of 4 mm in the right renal pelvis for which he did not receive any therapy. The patient brought 25 hard stones with irregular outline, 2-8 mm in diameter, of deep brown/grey colour that he claimed to have found in his underwear (figure 1)...
September 15, 2018: Archives of Disease in Childhood. Education and Practice Edition
Jean-Louis Bayart, Mélanie Closset, Alexandra Coulon, Raluca-Maria Furnica, Damien Gruson
Our team of diabetologist is challenged by the case of a 41 year-old woman with recurrent hypoglycaemic episodes. Her clinical background was complex with, among others, a neuroendocrine tumor, a nonalcoholic steatohepatitis and an adrenal insufficiency; these conditions require the exploration of several potential causes. After excluding an endogenous etiology, a factitious hypoglycemia was quicky suspected by clinicians. However, several venous samples showed normal insulinemia and a moderately decreased C-peptide...
August 1, 2018: Annales de Biologie Clinique
Raghavendra L Girijala, Rachel Falkner, Scott R Dalton, Brent D Martin
Factitial cheilitis is a rare diagnosis of exclusion that occurs most frequently in young women with a history of anxiety disorders and recent psychosocial stressors. It presents as continuous keratinaceous build-up, crusting, and desquamation of the lips, consistent with exfoliative cheilitis. Affected areas can progress to superinfection with Staphylococcus aureus or Candida albicans. We report a case of a 23-year-old woman who presented with diffuse hyperkeratosis of the upper and lower lips that was initially suspected to be allergic or irritant contact dermatitis based on clinical examination...
May 2, 2018: Curēus
C Moss, S M Srinivas, N Sarveswaran, M Nahorski, V K Gowda, F M Browne, G Woods
BACKGROUND: Midface toddler excoriation syndrome (MiTES) is a condition recently reported in three unrelated children. Habitual scratching from the first year of life inflicted deep, chronic, scarring wounds around the nose and eyes. One child had a mild neurological deficit but there was no other evidence of insensitivity to pain. Bilateral distribution and localization to the midface distinguish MiTES from other causes of self-inflicted skin damage such as trigeminal trophic syndrome...
November 2018: British Journal of Dermatology
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