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Psychocutaneous disorders are conditions characterized by psychiatric and skin manifestations, they are difficult to diagnose and a challenge to treat. Pathomimia is manifested by self-induced skin lesions, in order to attract more attention of the relatives and/or the medical staff. Depression and anxiety are the two most frequent psychiatric disorders among factitious disorders patients. Cooperation between dermatologists and psychiatrists, lead to significant improvement of those conditions. We report the case of a 67-year-old female with unknown psychiatric history and self-induced skin lesions of the lower limbs.Copy Right, IJAR, 2018. All rights reserved. …………………………………………………………………………………………………….... Introduction:Pathomimia also known as factitious disorders, are manifested by self-induced skin lesions in order to attract attention of family or medical staff. factitious disorders are classified as primary psychiatric disorders according to the DSM-V classification [1]. Depression and anxiety are the two most frequent psychiatric disorders among factitious disorders patients [2]. We report the case of a 67-year-old female with unknown psychiatric history and self-induced skin lesions of the lower limbs, and we insist therefore on the importance of the cooperation between dermatologists and psychiatrists, to diagnose these conditions, treat them and improve the quality of life of these patients. Clinical case:-A 67-year-old woman with unknown psychiatric problems, was hospitalized in our dermatology department for erosive skin lesions, covered with crusts, with discrete erythematous edges, accompanied by pruritus, located in the lower limbs (Figure 1). She described these lesions as being present for several months. She stated that she has already consulted many other dermatologists to resolve this problem without any clinical improvement despite the treatment received.Cutaneous examination failed to find other skin lesions, except dystrophic nails related to a trichophyton rubrum infection, and actinic keratosis related to the patient's age. and routine blood tests were within the normal range.A skin biopsy was performed, and the histopathological report excluded any of the known dermatosis.A psychiatric consult was demanded, the patient admitted the self-mutilation by causing the skin lesions herself, she did not claim any delusions of parasitosis. The psychiatric examination confirmed a diagnosis of anxiety and depression provoked by some critical episodes in her life: a serious neurological disease of her child, and poor socio-

Leukoaraiosis is a purely descriptive term for a radiological image, which describe confluent white matter abnormalities, detected by computed tomography (CT) or magnetic resonance imaging (MRI). The clinical presentation of this entity is heterogeneous and mostly severe. The relationship between Leukoaraiosis and depressive symptomatology is not yet completely understood. Ischemia seems to be the main favoring factor. Leukoaraiosis may be a risk factor for the onset, persistence, or worsening of depressive symptomatology in the elderly. Through a clinical case, we will address the different clinical and therapeutic aspects of this relationship.

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