State-of-the-Art Review: Evaluation and Management of Delusional Infestation.

Delusional infestation is a condition encountered frequently by healthcare professionals across a variety of specialties in which patients have a fixed, false belief that they are infested with living creatures, such as bugs, parasites, worms, or mites, or nonliving objects, such as fibers. Delusional infestation can be debilitating for patients, who not only present with intense psychological distress and physical discomfort but are also at risk of developing numerous dermatological and psychiatric complications. This condition poses unique diagnostic challenges, as these symptoms can occur secondary to many metabolic or infectious causes, as well as unique treatment challenges, with patients frequently refusing psychiatric care and consequently seeking evaluation by other healthcare professionals. In this review, we aim to use existing literature to provide clinicians in infectious diseases or other specialties with sufficient clinical context and treatment guidance for the appropriate management of delusional infestation.

Insights into the Medical Evaluation of Ekbom Syndrome: An Overview.

Ekbom syndrome, also known as delusional parasitosis (DP) or delusional infestation, is an uncommon psychiatric disorder distinguished by an enduring conviction of parasitic infestation, persisting notwithstanding the presence of medical evidence to the contrary. Primarily affecting middle-aged women, DP can manifest either as isolated psychological distress or as a component within a more intricate psychiatric framework, substantially influencing the quality of life for affected individuals. Its pathophysiological mechanism involves uncertain dopaminergic imbalances and dysfunction in the dopamine transporter system. Dermatologists often play a pivotal role in diagnosis, as patients first seek dermatological assessments of their signs and symptoms. However, DP frequently originates from underlying psychiatric disorders or medical variables, manifesting with neurological and infectious causative factors. The diagnostic complexity is attributed to patients' resolute convictions, leading to delayed psychiatric intervention. First-line DP treatment involves antipsychotics, with newer agents demonstrating promising prospects, but the lack of standardized protocols poses a significant therapeutic challenge. In this narrative review, both a comprehensive approach to this uncommon pathology and an update on the state of knowledge in this medical subfield focused on optimizing the management of DP are provided. The complexity of DP underlying its uncommon nature and the incomplete understanding of its pathophysiology highlight the need for further research through multicenter studies and multidisciplinary teams to enhance therapeutic efficacy and safety.

Psychological interventions in the treatment of delusional parasitosis: a brief review.

This review synthesized evidence on the most up-to-date treatment outcomes in patients with delusional parasitosis and examined the impact of incorporating psychological interventions in conjunction with psychiatric treatment. The reporting of this review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed and Google Scholar were searched between 2013 and 2023. Nine studies were included in this review. Partial remission was observed across all cases, irrespective of the treatment approach employed. Complete remission was limited to only three studies. No correlation was observed between the incorporation of psychological intervention in conjunction with psychotropic medication and an enhanced remission outcome. The findings underscore the importance of psychotropic medication as a fundamental component in the treatment of delusional parasitosis. The results highlight that although first- and second-generation psychotropic medications are the mainstay treatment options, they nevertheless play a limited role because of the patients' steadfast delusions of infestations.

Parasitosis ilusoria intestinal y dermatológica: casos clínicos / Delusional parasitosis intestinal and dermatological: clinical cases

Illusory parasitosis, better known as delusional parasitosis, is a neuropsychiatric syndrome in which patients have the belief of suffering a parasitic disease, that can not be demonstrated after an exhaustive medical study. These patients are characterized by being polyconsultants in different medical specialties and, many of them, have antecedents of psychiatric disorders, some of them undiagnosed. Knowing the existence of the clinical picture, diagnosing early and empathizing with the patient, could give to clinician some clues for a timely and assertive psychiatric referral, and improve patient adherence to the proposed treatment.

La parasitosis ilusoria, más conocida como delusión parasitaria, es un síndrome neuropsiquiátrico donde los pacientes tienen el convencimiento de padecer una infestación parasitaria, que no puede ser demostrada tras un exhaustivo estudio médico. Estos pacientes se caracterizan por ser policonsultantes en distintas especialidades médicas y, muchos de ellos, poseen antecedentes de trastornos psiquiátricos, algunos de ellos no diagnosticados. Conocer la existencia del cuadro, diagnosticar precozmente y empatizar con el paciente, pueden dar al médico clínico algunas claves para una derivación psiquiátrica oportuna y asertiva, y mejorar la adherencia del paciente al tratamiento propuesto. Se presentan cuatro casos clínicos que consultaron por esta extraña condición.

Psicodermatología en la atención primaria / Psychodermatology in primary care

The skin has the distinction of being the largest, visible and accessible part of the human body, and it hides a close and old relationship with the human psyche, and so has been demonstrated in the last years, where more elements of the Mental Health are elucidated playing a role in the pathogenesis of skin diseases, as well as there are some descriptions of the inverse relationship, this is, on how the skin diseases affect Mental Health of the individual. In this paper we propose to emphasize the importance of the issue, to consider a comprehensive approach to everyday Dermatology in Primary Care Medicine.

Síndrome de Ekbom: a propósito de un caso / Ekbom syndrome: apropos of a case

El síndrome de Ekbom o delirio de parasitosis es una condición psiquiátrica infrecuente cuyo síntoma principal es la idea delirante de estar infestado con organismos vivientes, como parásitos, bacterias, virus, insectos o gusanos. Se presenta el caso de un varón de 34 años con un cuadro compatible con este síndrome. Se revisa brevemente la literatura disponible y se realiza una correlación teórico-clínica con los síntomas del paciente, y se concluye que el paciente sufría un síndrome de Ekbom de tipo primario y mixto.

The Ekbom syndrome or delusional parasitosis is an uncommon psychiatric condition, in which the main symptom is the delusion of being infested with living organisms such as parasites, bacteria, virus, bugs or worms. The case is presented of a 34 year-old man with symptoms compatible with the syndrome. The available literature is briefly reviewed and theoretical correlation with clinical symptomatology is made. The patient had a primary and mixed Ekbom syndrome.

Delirio de infestación asociado a deterioro cognitivo leve de etiología vascular. Buena respuesta a dosis bajas de quetiapina / Delusional parasitosis associated to mild cognitive impairment of vascular causation. Good response to low doses of quetiapine

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