Factitial dermatitis

Factitial dermatitis, also known as dermatitis artefacta, is a self-inflicted skin condition where a patient consciously creates or aggravates skin lesions to fulfill an unconscious psychological need. The lesions can manifest in various forms, such as excoriations, ulcerations, burns, or rashes, and do not follow typical dermatological patterns. The patient often denies self-infliction.

This code is used when documentation clearly indicates a diagnosis of factitial dermatitis, implying intentional self-harm to the skin. It applies when a clinician identifies skin lesions that are inconsistent with known dermatological diseases and suspects or confirms a psychological origin for the self-inflicted injury. Supporting documentation should detail the nature of the lesions and the clinician's assessment of their factitious origin.

• Differentiate from malingering; factitial dermatitis involves an unconscious psychological need, not conscious deception for external gain.
• Do not code with F42.4 (Excoriation (skin-picking) disorder) as this is an Excludes1 note, indicating these conditions are mutually exclusive.
• Consider coding associated mental health conditions (e.g., anxiety, depression) if documented and treated.