Delusional infestations: clinical presentation, diagnosis and treatment

  title={Delusional infestations: clinical presentation, diagnosis and treatment},
  author={Misha M. Heller and Jillian W. Wong and Eric S. Lee and Barry Ladizinski and M Grau and Josephine L. Howard and Timothy G. Berger and John Koo and Jenny E Murase},
  journal={International Journal of Dermatology},
Patients with delusional infestations (DI), previously named delusions of parasitosis, have a fixed, false belief that they are infested with living or non‐living pathogens. Patients have abnormal cutaneous symptoms such as itching, biting, or crawling sensations. They often demonstrate self‐destructive behavior in an effort to rid the pathogens from under their skin, leading to excoriations, ulcerations, and serious secondary infections. This review article aims to provide an overview of DI… 
Delusional infestation: a prototype of psychodermatological disease
Clinically, DI is a diagnosis of exclusion, where the physician must rule out other medical conditions, including genuine dermatological disorders or infestations, or contributions from medications or substances, making it essential for all clinicians to be able to identify the disease.
Reframing delusional infestation: perspectives on unresolved puzzles
This review aims to discuss the following topics that currently confuse understandings of DI: the relationship of real/sham “infestation” with DI/MD; behavior alterations, such as self-inflicted trauma; neuroimaging abnormality and disturbance in neurotransmitter systems; and impaired insight in patients with this disease.
Delusional infestation: Clinical presentations, diagnosis, and management
Delusional infestation is a primary psychiatric disorder characterized by a somatic‐type delusional disorder (primary delusional infestation) that may lead to self‐induced cutaneous lesions which are
Delusions of parasitosis; suggested dialogue between dermatologist and patient
  • V. Patel, J. Koo
  • Psychology, Medicine
    The Journal of dermatological treatment
  • 2015
This article is a practical guide that suggests verbatim how dermatologists might talk to a delusional patient in order to establish a strong therapeutic rapport and strategies on how to optimize the initial encounter, build rapport and prescribe antipsychotic medications that are likely to be accepted by the patient.
Delusional parasitosis presenting as "Folie a Famille": Case report
A primary case of DP presenting as shared psychotic disorder (SPD) in the form of folie a famille, clinical picture and treatment process is presented, and olanzapine is used for treatment of primary case.
An Encapsulated Delusion of Photosensitivity
An unusual case of a middle-aged woman who presented to an outpatient psychodermatology clinic with a fixed, false belief that she had persistent and severe sensitivity to light, and was diagnosed with delusional disorder, somatic type and treated with pimozide is reported.
Delusional parasitosis with folie à deux: A case series
A case series of three cases of DP with shared psychotic disorder (folie ΰ deux) in which one individual developed a delusional belief in the context of a close relationship with another person or people who already had an established delusional idea.
Delusional Infestation Can Be a Complication of Prurigo Nodularis with Underlying Neuropathies.
2 patients with a long history of chronic pruritus of undefined aetiology that led to the development of delusional infestation are described.
The demand for skin biopsy from a patient with delusional parasitosis.


Delusional parasitosis: time to call it delusional infestation
The change in the name proposed by Freudenmann and Lepping from ‘delusional parasitosis’ to the all-encompassing term ‘Delusional infestation’ (DI) is supported, which better reflects the growing number of patients who do not believe they are infested by ‘parasites’ and captures all the various presentations.
Morgellons in dermatology
The delusional assumption of infestation with Morgellons should be considered as a new type of DP with some kind of inanimate material, and the use of the broader term “delusional infestation” is recommended.
Delusional parasitosis presenting as folie à trois: successful treatment with risperidone
Risperidone, an atypical antipsychotic that acts on serotonergic 5-HT2 and dopaminergic D2 receptors, has a much better safety profile than pimozide and is successful use in the treatment of a patient with DP and the subsequent resolution of symptoms of her husband and son who shared her delusions as folie à trois.
A clinical paradigm of delusions of parasitosis.
Delusions of parasitosis.
Delusional parasitosis: a new pathway for diagnosis and treatment
Delusional parasitosis is an uncommon disorder that presents particular challenges to the dermatologist and close collaboration of dermatologists and psychiatrists is recommended.
Delusional infestation and the specimen sign: a European multicentre study in 148 consecutive cases
Systematic studies of delusional infestation, also known as delusional parasitosis, are scarce and little is known about the specimens that patients provide to prove their infestation.
Delusions of parasitosis.
The fixed belief that one is infested with living organisms, in the absence of any objective evidence that such infestation exists, is termed "delusions of parasitosis." For most patients, this is a
Delusions of Parasitosis
Atypical antipsychotics such as risperidone with a much safer adverse effect profile may prove to be effective for the treatment of delusions of parasitosis in the future.