Dermatitis artefacta or factitious disease may be unrecognized in children. We present a 12-year-old girl who had an unusual facial lesion on the chin, which was self-inflicted but histologically mimicked cutaneous T-cell lymphoma. Our report emphasizes both the potential diagnostic pitfalls and the importance of clinicopathologic correlation.

Acute intermittent porphyria (AIP) is rare in Europeans, with an estimated prevalence of 1-2 per 100 000.1 Acute attacks of porphyria cause severe abdominal pain and a range of neurological and other features, including hypertension, tachycardia and excessive sweating. Some of the clinical features of AIP have been attributed to adrenergic hyperactivity.