Introduction:Genodermatoses associated with malignant tumors constitute a diagnostically important group of dermatological diseases. One of them is the Birt-Hogg-Dube syndrome, characterized by numerous fibrofolliculomas, trichodiscomas, (benign nodules originating from hair follicles), lung cysts and an increased risk of kidney cancer. Case report: A 81-year-old man was admitted to our clinic with erythematous-edematous, bullous and erosive skin lesions located on his trunk and limbs. During hospitalization, bullous pemphigoid and two types of basal cell carcinoma were diagnosed. Additionally, attention was paid to the presence of numerous flesh-colored papules on the surface of the face, neck and ears, corresponding to fibrofolliculoma in the histopathological examination. An in-depth medical history and detailed imaging diagnostics allowed the patient to be diagnosed with the Birt-Hogg-Dubé syndrome. Conclusions: Characteristic skin lesions and coexisting extra-cutaneous symptoms in Birt-Hogg-Dube syndrome allow early identification of patients at increased risk of kidney cancer. We describe the first case of Birt-Hogg-Dube syndrome associated with bullous pemphigoid and basal cell carcinoma.
Introduction. Delusional parasitosis is a psychotic disorder characterized by an isolated delusional judgment about the presence of parasites moving under or in the skin. Objective. Presentation of a case of delusional parasitosis in a patient treated with psychoactive drugs. Case report. A 73-year-old woman was admitted to the hospital because of extensive erosive skin lesions. Skin lesions with associated itching have been present for about 7 years. The patient associated them with a parasitic infection with nematodes. The patient reported that she was intentionally infected by a person that she met in a public place. Testing for parasitic infestations gave repeatedly negative results. The patient was treated with antiparasitic preparations with no satisfactory improvement. Histology image showed features corresponding to prurigo nodularis. After consultation with a psychiatrist, during the hospital stay, the antipsychotic treatment with olanzapine was started at the dose of 10 mg/day with a good response to treatment. Conclusions. Knowledge of psychodermatological conditions in everyday clinical practice may contribute to the improvement of diagnostics and faster implementation of effective treatment of psychodermatoses. streszczenie Wprowadzenie. Obłęd pasożytniczy jest zaburzeniem psychotycznym, charakteryzującym się pojedynczym sądem urojeniowym co do obecności pasożytów poruszających się pod skórą i/lub w skórze. Cel pracy. Przedstawienie przypadku obłędu pasożytniczego u pacjentki leczonej lekami psychiatrycznymi. Opis przypadku. Kobieta 73-letnia została przyjęta na oddział z powodu rozległych zmian nadżerkowych na skórze. Zmiany skórne ze świądem występowały od około 7 lat. Pacjentka wiązała je z infekcją pasożytniczą nicieniami. Twierdziła, że została celowo zarażona przez osobę przypadkowo spotkaną w miejscu publicznym. W wielokrotnie wykonanych badaniach w kierunku potwierdzenia infekcji pasożytniczej uzyskiwała wyniki ujemne. Leczona preparatami przeciwpasożytniczymi -bez zadowalającej poprawy. W obrazie histologicznym stwierdzono obraz mogący odpowiadać prurigo nodularis. Po konsultacji z lekarzem psychiatrą w trakcie pobytu w szpitalu włączono lecze-
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