{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:55:04Z","timestamp":1791273304730,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    DA is an uncommon psychocutaneous disorder in which the patient intentionally induces lesions to satisfy a subconscious psychological need and, at the same time, denies self\u2010harm. DA typically presents as bizarre, well\u2010demarcated lesions in accessible areas. Diagnosis is based on the suspicion and exclusion of organic causes. A 27\u2010year\u2010old married woman presented with painful, slow\u2010healing ulcers on the dorsum of both hands and forearms for 2\u2009months, along with body pain and progressive hair loss. The patient had epilepsy, which was controlled with sodium valproate and carbamazepine, although she had occasional psychogenic non\u2010epileptic seizures (PNES). She denied systemic symptoms, like fever or arthralgia. Examination revealed irregular punched\u2010out ulcers with erythematous borders, crusting, and post\u2010inflammatory hyperpigmentation and infection or signs of systemic illness. Investigations revealed leukocytosis (TLC 19.1\u2009\u00d7\u200910\n                    <jats:sup>9<\/jats:sup>\n                    \/L), while the brain CT was normal. Skin biopsy revealed epidermal ulceration, necrosis, and mixed inflammatory infiltrates without vasculitis or pathogenic organisms. The patient was admitted to the hospital to manage her lesions when experiencing anxiety attacks, thereby confirming DA. This case represents the typical features of DA: self\u2010inflicted geometric lesions on accessible sites in a young woman with psychological stressors. The coexistence of epilepsy and pseudoseizures reflects a psychoneurological interaction whereby chronic illness and emotional instability may be the instigators of maladaptive behavior. Management requires a multidisciplinary approach involving dermatology, psychiatry, and neurology. Supportive topical therapy and cognitive\u2010behavioral therapy resulted in better emotional regulation, adequate sleep, and ulcer healing. Empathetic, integrated management ensures recovery and prevents the recurrence of DA.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.73411","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:31:26Z","timestamp":1788244286000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When Mind Hurts the Skin: A Rare Case of Dermatitis Artefacta in an Epileptic Female"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2787-4564","authenticated-orcid":false,"given":"Maaz","family":"ullah","sequence":"first","affiliation":[{"name":"Department of Medicine Bannu Medical College  Bannu Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9771-1339","authenticated-orcid":false,"given":"Tayyeb","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Medicine Gomal Medical College Dera Ismail Khan  Dera Ismail Khan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1800-1800","authenticated-orcid":false,"given":"Muhammad Hassaan","family":"Javaid","sequence":"additional","affiliation":[{"name":"Department of Medicine Shifa College of Medicine Islamabad  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0717-2777","authenticated-orcid":false,"given":"Muddassir","family":"Khalid","sequence":"additional","affiliation":[{"name":"Department of Medicine Nishtar Medical University  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7469-2875","authenticated-orcid":false,"given":"Naveed","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Medicine Khyber Medical College Peshawar  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0797-2246","authenticated-orcid":false,"given":"Farooq","family":"Haider","sequence":"additional","affiliation":[{"name":"Department of Medicine Khyber Medical College Peshawar  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5747-6507","authenticated-orcid":false,"given":"Okasha","family":"Tahir","sequence":"additional","affiliation":[{"name":"Department of Medicine Khyber Medical College Peshawar  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munazza","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Medicine Khyber Girls Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadia","family":"Afridi","sequence":"additional","affiliation":[{"name":"Department of Medicine Khyber Girls Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ejaz","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Medicine Chengde Medical University  Chengde China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7441-9135","authenticated-orcid":false,"given":"Fred","family":"Segawa","sequence":"additional","affiliation":[{"name":"Department of Medicine Makerere University College of Health Sciences  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.2165\/00128071\u2010200001010\u201000005"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.20nr02858"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/15569527.2013.791830"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.5144\/0256\u20104947.1999.223"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/12034754251355589"},{"issue":"9","key":"e_1_2_13_7_1","article-title":"An Insight Into Adolescent Dermatitis Artefacta: A Case Report","volume":"16","author":"Gupta M.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_13_8_1","volume-title":"StatPearls","author":"Chandran V.","year":"2025"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.5826\/dpc.1402a53"},{"issue":"4","key":"e_1_2_13_10_1","first-page":"209","article-title":"Diagnostic Clues to Dermatitis Artefacta","volume":"63","author":"Joe E. 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