Delusional Parasitosis in a School Teacher Living in a Rural Area: Parasitological Approach

Area of Science:

• Psychiatry
• Dermatology
• Parasitology

Background:

• Delusional parasitosis is a psychiatric condition characterized by the false belief of infestation.
• Patients often present with excoriations due to self-inflicted scratching in attempts to remove perceived parasites.

Observation:

• A 58-year-old female reported an eight-month history of crawling sensations and itching, believing her skin was infested with insects and worms.
• Physical examination revealed self-inflicted skin lesions, and microscopic examination of skin scrapings ruled out parasitic infections.
• Despite extensive physician visits, the patient's delusions persisted until treated.

Findings:

• The patient was treated with amisulpride 100 mg twice daily, leading to complete remission of delusions within five weeks.
• Skin lesions were managed concurrently with clobetasol propionate ointment.

Implications:

• This case highlights the importance of a thorough clinical examination and parasitological testing in diagnosing delusional parasitosis.
• Effective management involves addressing both the psychotic symptoms with antipsychotics and the dermatological manifestations.