PS01 Dermatitis artefacta in a paediatric population: clinical insights from a retrospective review
Bibliographic record
Abstract
Abstract Dermatitis artefacta (DA) is a functional disorder involving deliberate skin damage, which is under-reported in the paediatric population. Patients generally refuse or are vague when prompted to reveal the pathogenesis and tend to deny involvement in creating the skin lesions, which can create anxiety within families. The underlying cause for this behaviour is complex and requires a measured, patient-centred approach, focusing on the psychological basis rather than the method of action. A retrospective review was conducted of 20 patients diagnosed with DA attending the paediatric psychodermatology clinic, at a tertiary centre in the UK, between March 2020 and December 2024. To our knowledge, there have been few reported case series regarding DA in the UK paediatric population. The study objective was to explore the various clinical presentations and strategies employed to treat DA in our paediatric population. We also aimed to review clinical outcomes in order to evaluate the effectiveness of management and to inform future clinical guidelines. All patients referred to the clinic, and attending, were female. Patients’ ages ranged from 9 to 16 years (mean 13). A diverse range of ethnicities was also present reflecting the local population, with a predominance of White British (40%). One-quarter of patients had comorbidities that were not skin related and one-quarter had skin-related coexisting pathology (eczema or acne). Three patients (15%) had a psychological history (autism or obsessive–compulsive disorder). We performing a thematic analysis and applied Moss’s classification (Moss C. Dermatitis artefacta in children and adolescents. Paediatr Child Health 2015; 25: 84–9). This highlighted that the underlying strategy for DA most commonly seen was ‘coping’ (60%), with ‘recreational’ accounting for one-quarter of patients seen. On average, patients were under the care of the psychodermatology clinic for a total of 319 days before being discharged. Our case series highlights that the model used within a multidisciplinary paediatric psychodermatology clinic, involving a dermatologist and a clinical psychologist, is important to achieve a more timely diagnosis and enable appropriate intervention. We analyse themes present within our patients and correlate these to reported risk factors (bullying, sexual abuse) and to psychological associations (anxiety, depression), with consideration of how these are incorporated into clinical management strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.005 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".