Delusional parasitosis is a mistaken belief that parasites have infested the body.
People with delusional parasitosis have an unshakable, false belief that they are infested with insects, worms, mites, lice, fleas, or other organisms. Some people also believe the parasites have infested their home, surroundings, and clothing. They often provide vivid descriptions of how the organisms enter their bodies via their skin and other body openings and move around.
The sensations of itching, crawling, and irritation are very real to them. In an effort to rid themselves of these sensations, people may scratch, pick at, or mutilate their skin enough to cause sores or ulcers. Such sores then sometimes become infected. Other people apply various chemicals and/or disinfectants to their skin. Such chemicals may cause skin irritation or allergic reaction.
People bring samples of hair, skin, and debris, such as dried scabs, dust, and lint, to their doctor to prove the infestation is real. People may put the samples on a microscope slide or carry them in a container. Delusional parasitosis most often affects people over 50 and women but is very rare.
Some people with delusional parasitosis may have a disorder that causes them to excessively worry about their health (illness anxiety disorder, formerly known as hypochondriasis), or they may have become aware of some parasitic disorder (for example, scabiesSymptoms/Delirium tremens...).
Diagnosis of Delusional Parasitosis
A doctor's evaluation
Delusional parasitosis is sometimes difficult for doctors to diagnose because many actual skin disorders, such as allergies, dermatitis, or real parasites, also cause the itching sensations. Also, skin sores or irritation caused by the person's scratching and use of chemicals may look like other skin disorders.
Doctors base the diagnosis on a physical examination and the person's history, including any history of medication or substance use or mental disorders. Doctors may do skin scrapings and sometimes blood tests to rule out real infestations and other diseases. If a real infestation has been ruled out, examination by a doctor who specializes in mental health conditions (psychiatrist) may be helpful to determine whether delusional parasitosis is part of a mental health condition.
Treatment of Delusional Parasitosis
Psychiatric therapy
Sometimes medications
Delusional parasitosis treatment is best coordinated between a doctor who specializes in skin disorders (called a dermatologist) and a psychiatrist. The dermatologist does a thorough evaluation to make sure that there are no actual parasites. The person is then referred to a psychiatrist so that their delusion can be treated.
People who have symptoms of obsessive compulsive disorder may benefit from a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI).
