Richard Fried

Are You Confident of the Diagnosis? What you should be alert for in the history The history is marked by a tendency to pick at skin lesions or “imperfections.” Characteristic findings on physical examination Characteristic findings include excoriated acne lesions ranging from superficial excoriated lesions to deep excoriations and scarring (Figure 1). Angulated configuration from…

Are You Confident of the Diagnosis? Rule out factitious, malingering, and abuse. What you should be alert for in the history Be alert for predictable bruising associated with psychological stress in the absence of a hematologic, vascular, immunologic, or infectious process. Characteristic findings on physical examination Characteristic findings include unexplained painful, ecchymotic lesions, mostly on…

Are You Confident of the Diagnosis? What you should be alert for in the history Patients with body dysmorphic disorder (BDD) show an obsessive preoccupation with real or imagined cosmetic imperfection or defect: acne, scars, pigmentation, oiliness, redness, paleness, facial vessels, hair loss, excessive facial hair. Complaint may involve a dysesthesia (ie, burning, itch, crawling…