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Uncommon ulceration on the lower lip.

Abstract Cutaneous pathomimia is a self-induced disease characterized by conscious self-injury to mucocutaneous boundary or its phaneres. We report the case of a 22-year old woman, with no notable medical history, presenting with sudden onset ulceration on her lower lip evolving for 3 months in a context of preservation of patient's clinical status. The patient had previously consulted several dermatologists and had undergone two skin biopsies with non-specific histological diagnosis. Clinical examination showed painful, well-defined ulceration with clean surface and non-indurated basis, measuring 1 × 3 cm in diameter and involving the left half of the lower lip (A). Given the clinical appearance of the lesion, its chronic nature and the lack of response to local care, several diagnosis were suspected: squamous cell carcinoma, cutaneous leishmaniasis, pyoderma gangrenosum… Deep biopsy was performed showing a loss of substance revealing the chorion, without histological characters of malignancy. Syphilis and HIV tests were negative. Fifteen days after, patient's evolution was marked by the appearance of an identical lesion on the right side of the lower lip, with complete healing of the former lesion by occlusive dressing (B). The follow-up interview showed, again, manipulation with the hand as well as family conflicts. Examination by a psychiatrist compared with clinical and evolutionary data showed cutaneous pathomimia.
PMID
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Authors

Mayor MeshTerms
Keywords

Pathomimia

lip

ulceration

Journal Title the pan african medical journal
Publication Year Start




PMID- 29541326
OWN - NLM
STAT- MEDLINE
DCOM- 20180322
LR  - 20180322
IS  - 1937-8688 (Electronic)
VI  - 28
DP  - 2017
TI  - [Uncommon ulceration on the lower lip].
PG  - 180
LID - 10.11604/pamj.2017.28.180.13953 [doi]
AB  - Cutaneous pathomimia is a self-induced disease characterized by conscious
      self-injury to mucocutaneous boundary or its phaneres. We report the case of a
      22-year old woman, with no notable medical history, presenting with sudden onset 
      ulceration on her lower lip evolving for 3 months in a context of preservation of
      patient's clinical status. The patient had previously consulted several
      dermatologists and had undergone two skin biopsies with non-specific histological
      diagnosis. Clinical examination showed painful, well-defined ulceration with
      clean surface and non-indurated basis, measuring 1 x 3 cm in diameter and
      involving the left half of the lower lip (A). Given the clinical appearance of
      the lesion, its chronic nature and the lack of response to local care, several
      diagnosis were suspected: squamous cell carcinoma, cutaneous leishmaniasis,
      pyoderma gangrenosum... Deep biopsy was performed showing a loss of substance
      revealing the chorion, without histological characters of malignancy. Syphilis
      and HIV tests were negative. Fifteen days after, patient's evolution was marked
      by the appearance of an identical lesion on the right side of the lower lip, with
      complete healing of the former lesion by occlusive dressing (B). The follow-up
      interview showed, again, manipulation with the hand as well as family conflicts. 
      Examination by a psychiatrist compared with clinical and evolutionary data showed
      cutaneous pathomimia.
FAU - Naciri, Ilhame
AU  - Naciri I
AD  - Service de Dermatologie et Venerologie, Centre Hospitalier Universitaire Ibn
      Sina, Faculte de Medecine et de Pharmacie, Universite Mohammed V, Rabat, Maroc.
FAU - Senouci, Karima
AU  - Senouci K
AD  - Service de Dermatologie et Venerologie, Centre Hospitalier Universitaire Ibn
      Sina, Faculte de Medecine et de Pharmacie, Universite Mohammed V, Rabat, Maroc.
LA  - fre
PT  - Case Reports
PT  - Journal Article
TT  - Une ulceration atypique de la levre inferieure.
DEP - 20171027
PL  - Uganda
TA  - Pan Afr Med J
JT  - The Pan African medical journal
JID - 101517926
SB  - IM
MH  - Biopsy
MH  - Female
MH  - Humans
MH  - Lip/pathology
MH  - Lip Diseases/*diagnosis/etiology
MH  - Self-Injurious Behavior/*diagnosis
MH  - Ulcer/*diagnosis/etiology
MH  - Young Adult
PMC - PMC5847262
OTO - NOTNLM
OT  - Pathomimia
OT  - lip
OT  - ulceration
EDAT- 2018/03/16 06:00
MHDA- 2018/03/23 06:00
CRDT- 2018/03/16 06:00
PHST- 2017/09/22 00:00 [received]
PHST- 2017/10/18 00:00 [accepted]
PHST- 2018/03/16 06:00 [entrez]
PHST- 2018/03/16 06:00 [pubmed]
PHST- 2018/03/23 06:00 [medline]
AID - 10.11604/pamj.2017.28.180.13953 [doi]
AID - PAMJ-28-180 [pii]
PST - epublish
SO  - Pan Afr Med J. 2017 Oct 27;28:180. doi: 10.11604/pamj.2017.28.180.13953.
      eCollection 2017.