Delusional parasitosis or Ekbom's Syndrome

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Delusional Parasitosis

 

Introduction

Clinical Manifestations

Sufferer's View

History

Causes

Diagnostic Protocols

Treatments

Services

References

 

Introduction

 

Delusional Parasitosis is a mistaken belief that one is being infested by

parasites such as mites, lice, fleas, spiders, worms, bacteria, or other

organisms. (If of interest, please read from the sufferer's view.) This site has

been created in an attempt to centralize accurate information on this

misunderstood and increasingly common syndrome.

 

Definition

 

Delusional parasitosis or Ekbom's Syndrome is a rare disorder in which

sufferers hold a delusional belief they are infested with parasites. A related

symptom involving a tactile hallucination of insects, snakes, or other vermin

crawling over the skin is known as formication. The origin of this word is from

the Latin formica, " ant " .

 

It is not to be confused with Wittmaack-Ekbom or restless legs syndrome.

Unfortunately, this is also referred to in short as " Ekbom's Syndrome " leaving

the audience having to infer the particular meaning from the context. It is

named after a Swedish neurologist, Karl Axel Ekbom, who published seminal

accounts of the disease in 1937 and 1938.

 

The sufferer typically reports parasites to exist under the skin, around or

inside body openings, in the stomach or bowels and may include a belief that the

parasites infest the sufferer's home, surroundings or clothing.

 

A person holding such a belief may approach doctors or dermatologists asking

for treatment for the supposed infestation, and will often bring small

particles, dust, skin flakes and other material for the doctor to inspect. Since

the material may be carried in an envelope or matchbox, this presentation is

known as the " matchbox sign. "

 

Stimulant drug abuse (particularly amphetamine and cocaine) can lead to

delusional parasitosis. For example, excessive cocaine use can lead to an effect

nicknamed " cocaine bugs " where the affected person believes he has, or feels

parasites crawling under his skin. These conditions are also associated with

high fevers and extreme alcohol withdrawal, often associated with visual

hallucinations of insects.

 

People suffering from these conditions may scratch themselves to the extent of

serious skin damage and bleeding, especially if they are delirious or

intoxicated.

 

© 2005 Bohart Museum of Entomology

 

http://delusion.ucdavis.edu/delusional.html

 

Clinical Manifestations

 

The Sufferer:

Has suffered from the infestation for a long time.

Has been seen by numerous physicians, exterminators, parasitologists,

hygienists and entomologists.

Consistently and fiercely rejects negative findings or any that deviate from

their perceptions of the infestation.

May exhibit the " matchbox sign " , where sufferers deliver or mail containers

holding samples consisting of dust, lint, skin scrapings, toilet paper, dried

blood or scabs, hair or other pieces of human tissue.

May engage in self mutilation, ranging from scratches to deep ulceration.

These can occur where the patient has attempted to dig out the parasites.

Uses home remedies and distrusts of prescription drugs.

Has exposed themselves to often dangerous levels of pesticides.

 

 

 

One or More " Familiy Members " May Share The Delusion:

Folie à deux - two family members involved, usually husband and wife or

parent and child.

Folie à partagee - three or more family members involved.

 

 

 

The infestation is described by the sufferer as located:

In, on or under the skin

Around or just inside body openings or in sputum.

Internally, particularly in the stomach or intestines.

In the vicinity of the sufferer, particularly in the home.

http://delusion.ucdavis.edu/manifest.html

 

Treatments

 

Management of patients with delusional parasitosis is best handled through the

cooperation of dermatologists, psychiatrists, and entomologists or

parasitologists. Psychiatrists are needed to confirm the diagnosis of delusional

parasitosis and to make the diagnosis of any underlying psychiatric disorder in

the case of secondary functional delusional parasitosis. In addition,

psychiatrists are able to conduct psychotherapy and provide a long-term

commitment during the treatment phase. Sufferers are often reluctant to consult

a psychiatrist, and if the suggestion to do so is not done carefully, the

patient may seek help from another physician. Dermatologists need to be

supportive about the patient’s symptoms and suffering and should suggest that a

psychiatrist may be able to help the patient live with the problem more

comfortably. Some patients may be able to live with their infestation without

drug or psychiatric treatment by receiving the reassurance given by careful

examination of any specimens brought in and by periodic consultations with the

physician.

 

 

There are some essential points to keep in mind when working with an

individual suffering from delusional parasitosis.

 

Empathize with the patient's distress and frustration.

Examine specimens and explain that there are no insects or mites in the

specimen(s).

Remind the sufferer of the numerous steps they have taken and that laboratory

studies have shown nothing.

It is pointless to argue with the sufferer as there is no way to sway them.

Never agree with the patient, you will only make the situation worse.

 

 

It is essential to rule out the presence of environmental irritants and/or

actual parasites, allergens, or other organisms that cause contact dermatitis.

Although many arthropods may bite humans, for the majority of species these

would be unusual occurrences. The only groups likely to cause ongoing problems

include mites, fleas and lice.

 

http://delusion.ucdavis.edu/treatment.html

see site for more info

 

 

 

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