A case series of shared delusional infestation: folie à deux revisited.

Delusional infestation describes the unshakeable belief that one's skin is infected or infested with an external organism or inanimate material, in the absence of supportive medical evidence. It is one of the most challenging psychodermatological conditions to manage, given the rigidity of patients' physically focused health beliefs, and the competing need to introduce antipsychotic therapy to bring about resolution. This is rendered exponentially more complex when partners or family members are similarly afflicted. This situation is known as shared delusional infestation, shared psychotic disorder (SPD), or folie à deux. We present a series of three couples with SPD who were referred to our tertiary psychodermatology service during the same year. On examining the literature we were intrigued to discover that subtly different subtypes of SPD have been recognized since the late 1800s. These include folie simultanée, imposée, communiquée and induite. Our cases neatly demonstrate three of these variants, and highlight the difficulties in facilitating effective treatment.

A retrospective review of 12 patients with trichotillomania treated in a psychodermatology service.

Trichotillomania is a condition characterized by the pulling of hair from anywhere on the body and is classified as an obsessive-compulsive and related disorder. Patients with hair disorders are commonly referred to psychodermatology services, and can represent a management challenge. Few publications exist that report outcomes for patients with trichotillomania in real clinical practice. We report 12 such patients seen within our own psychodermatology service, who were managed using a variety of treatment strategies. The rate of defaulting of appointments was high, but improvements were seen in patients engaging with services.

Fourier transform infra-red spectroscopy using an attenuated total reflection probe to distinguish between Japanese larch, pine and citrus plants in healthy and diseased states.

FTIR spectroscopy coupled with an Attenuated Total Reflection (ATR) sampling probe has been demonstrated as a technique for detecting disease in plants. Spectral differences were detected in Japanese Larch (Larix kaempferi) infected with Phytophthora ramorum at 3403cm(-1) and 1730cm(-1), from pine (Pinus spp.) infected with Bursaphelenchus xylophilus at 1070cm(-1), 1425cm(-)1, 1621cm(-1) and 3403cm(-1) and from citrus (Citrus spp.) infected with 'Candidatus liberibacter' at 960cm(-1), 1087cm(-1), 1109cm(-1), 1154cm(-1), 1225cm(-1), 1385cm(-1), 1462cm(-1), 1707cm(-1), 2882cm(-1), 2982cm(-1) and 3650cm(-1). A spectral marker in healthy citrus has been identified as Pentanone but is absent from the diseased sample spectra. This agrees with recent work by Aksenov, 2014. Additionally, the spectral signature of Cutin was identified in the spectra of Pinus spp. and Citrus spp. and is consistent with work by Dubis, 1999 and Heredia-Guerrero, 2014.

Tissue viability. Post-operative wounds: a nurse-led change in wound dressings.

In an attempt to ascertain whether the type of dressing used in hip replacement surgery can affect the risk of patients haemorrhaging post-operatively, a survey was carried out on a 25-bedded orthopaedic ward. It was found that thinly dressed wounds were more likely to lead to haemorrhage. As a result of this nursing-led initiative, the consultants agreed to use thickly padded dressings and there has since been a reduction in the number of patients haemorrhaging.