The patient's denial of psychological distress and negative feelings aroused in healthcare personnel make management difficult.
[statpearls.com]
[…] is observed in many studies and reports of dermatitis artefacta. [4],[9],[10] For the diagnosis of dermatitis artefacta, there are some diagnostic clues, [11],[12] like denial
[ijdvl.com]
[…] lesions, chronic evolution, bizarre forms of skin lesions that are found on accessible parts of the body and that do not resemble any of the known dermatoses, the continuous denial
[dovepress.com]