Religious stigmata as malingering artifact: Report of a case and review of the literature

RATIONALE: Artifacts or simulated diseases are self-inflicted conditions caused by various means and for different purposes. Disease simulation can be motivated, among other things, by illegal purposes, to escape from civil duties or prison sentences, for example, or to exploit specific situations in order to receive a range of benefits. In such cases, the simulator is fully aware of his or her actions and intentions. DIAGNOSES, INTERVENTIONS AND OUTCOMES: We report the case of a 42-year-old woman who, for 3 consecutive years, showed religious stigmata on the forehead and on the dorsal surface of hands and feet immediately before Easter. Lesions showed an acute onset, manifested as erosions and ulcerations, and healed a few days after Easter. Stigmata were immediately made public and every year faithful and curious people went in procession to the house of the patient, offering different kinds of gifts. After intervention of the police authority in the early days of the third episode, the patient and her family repented of their actions. Cutaneous lesions healed in few days and similar events did not occur during the following 2 years. LESSONS: Regardless of personal beliefs, the possibility that stigmata could be self-inflicted for illegal or profit purposes should always be considered.