Delusional parasitosis (Ekbom syndrome) – a psychodermatologic disorder

Abstract

Introduction. Delusional parasitosis is a psychotic disorder characterized by an isolated delusional judgment about the presence of parasites moving under or in the skin. Objective. Presentation of a case of delusional parasitosis in a patient treated with psychoactive drugs. Case report. A 73-year-old woman was admitted to the hospital because of extensive erosive skin lesions. Skin lesions with associated itching have been present for about 7 years. The patient associated them with a parasitic infection with nematodes. The patient reported that she was intentionally infected by a person that she met in a public place. Testing for parasitic infestations gave repeatedly negative results. The patient was treated with antiparasitic preparations with no satisfactory improvement. Histology image showed features corresponding to prurigo nodularis. After consultation with a psychiatrist, during the hospital stay, the antipsychotic treatment with olanzapine was started at the dose of 10 mg/day with a good response to treatment. Conclusions. Knowledge of psychodermatological conditions in everyday clinical practice may contribute to the improvement of diagnostics and faster implementation of effective treatment of psychodermatoses.