Factitial dermatosis of the breast: a possible dermatologic manifestation of Munchausen's syndrome

We report on two cases of factitial dermatosis of the breast associated with benign fibrocystic disease. One of the patients could also be diagnosed as showing Munchausen's syndrome. The lesions were protracted and intractable, painful ulcers that recurred and eventually became bilateral, despite attempts at surgical correction. The management of factitial dermatosis of the breast is complex, and should include psychiatric referral as well as avoidance of further surgical treatment if possible.