Abstract
A case of a unique factitious disorder resulted from self-inducement of oral lacerations, erosions, and abrasions. Previous medical investigations included evaluations by two general dentists, one oral surgeon, two periodontists, one internist, one otolaryngologist, and one infectious-disease physician. The patient had two gingival biopsies and one hospitalization. The lesions were unresponsive to several therapeutic regimens including temporary discontinuation of tooth brushing, antibiotics, and gingival dressings. The differential diagnosis included infectious, nutritional, immunologic, and factitious disorders. An apparent initial response to corticosteroids suggested the possibility of an immunologic inflammatory disease; however, no organic cause could be found. The enigma was resolved by discussion with the patient who reported that the lesions were self-induced and the manner in which this was done.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 44-46 |
| Number of pages | 3 |
| Journal | The Journal of allergy and clinical immunology |
| Volume | 75 |
| Issue number | 1 PART 1 |
| DOIs | |
| State | Published - Jan 1985 |
Funding
A case of a unique factitious disorder resulted from self-inducement of oral lacerations, erosions, and abrasions. Previous medical investigations included evaluations by two general dentists, one oral surgeon, two periodontists, one internist, one otolaryngologist, and one infectious-disease physician. The patient had two gingival biopsies and one hospitalization. The lesions were unresponsive to several therapeutic regimens including temporary discontinuation of tooth brushing, antibiotics, and gingival dressings. The differential diagnosis included infectious, nutritional, immunologic, and factitious disorders. An apparent initial response to corticosteroids suggested the possibility of an immunologic injammatory disease; however, no organic cause could be found. The enigma was resolved by discussion with the patient who reported that the lesions were self-induced and the manner in which this was done. (J ALLERGY CLIN IMM!INOL 75:44-6, 1985.) The diagnosis of factitious illness may be extremely difficult and may take years to resolve generating enormous medical expenses. ’ Often the illnesses are consciously and intentionally motivated without a clear ulterior motive or cause. Motivations may be the gaining of sympathy, guilt, or to seek monetary compensation. Revenge may also be involved, often directed against medical personnel. * The subject of oral factitious injuries has been previously reviewed3”; however, there has been no report of self-induced oral lesions presenting as an immunologic disorder. Self-inflicted oral injuries may involve soft tissue, bone, and tooth structures. Children are more often involved than adults, and coexistent emotional problems are frequently present; however, in some cases there may be no discernible emotional component. 3 We report a case of self-induced mouth lesions re- From the Sections of Allergy-Immunology and General Medicine, Department of Medicine and the Department of Periodontics, Northwestern University Medical School and Dental School, Chicago, 111. Supported by United States Public Health Service grant AI 11403 and the Ernest S. Bazley Grant. Received for publication March 23, 1984. Accepted for publication June 12, 1984. Reprint requests: Roy Patterson, M.D., 303 E. Chicago Ave., Chi-cago, IL 60611.
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology