Delusional infestation: a case series from a university dermatology center in São Paulo, Brazil

Martins, Ana; Mendes, Carolina P.; Nico, Marcello Menta Simonsen

doi:10.1111/ijd.13004

Cited by 20 publications

(13 citation statements)

References 16 publications

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“…We present 8-case series of DP patients who were treated with aripiprazole. The gender characteristic of our sample was not consistent with previous observations that can be described as female predominance [6,11]. In our cases, five (%62.5%) of the patients were male.…”

Section: Discussioncontrasting

confidence: 97%

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Aripiprazole as a treatment option for delusional parasitosis: case series of 8 patients

Çınar

Kutlutürk

Ertek

et al. 2019

Psychiatry and Clinical Psychopharmacology

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OBJECTIVE: Delusional parasitosis (DP), also known as Ekbom's Syndrome, is a rare, generally monosymptomatic disorder that characterizes with the fixed belief of being infected by parasites without any evidence of medical or microbiological proof. These patients are examined in dermatology and infection clinics with symptoms and signs of pruritus, skin and subcutaneous scars secondary to itching. Primary DP is diagnosed when no etiological factor is detected while secondary DP arises from underlying physical or mental disorder. Formerly, pimozide was the commonly preferred choice of treatment with cases of DP. However, there is growing evidence that second-generation antipsychotics and antidepressants can be used in the treatment of DP. In this study, the usage of aripiprazole in the treatment of DP cases is presented. METHODS: 8 patients with the diagnosis of primary DP were evaluated in terms of demographic data, clinical variables and responses to treatment. A psychiatric diagnosis was made based on a clinical interview performed using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) SCID-I. The patients were followed for six months. Three patients were female, five patients were male. The average age of the patients was 57.5. Four patients had essential hypertension as comorbidity. The duration of the symptoms ranged from 6 to 48 months with an average of 24.75 months. All of our 8 cases were consulted by the dermatology department. The patients were performed Hamilton Depression Scale (HDS) and Mini-Mental Status Examination (MMSE). Eight patients were treated with aripiprazole 10 or 15 mg/day, and no dose alteration was made. RESULTS: From the patients who were treated with aripiprazole, seven (87.5%) patients had complete remission after three months, eight (100%) patients achieved complete remission after six months. DISCUSSION: The earliest drug choice for patients with DP was pimozide, but because of the extrapyramidal side effects and cardiac side effects like QTc prolongation, second-generation antipsychotics are being investigated for treatment. Various researches are available related to the usage of second-generation antipsychotics like risperidone, olanzapine, paliperidone, ziprasidone, quetiapine, and aripiprazole in the cases with DP. This study shows that aripiprazole can be a successful treatment choice for DP, but further studies are needed for this topic.

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Section: Discussioncontrasting

confidence: 97%

“…In our cases, five (%62.5%) of the patients were male. However, our cases consisted of older patients compatible with the previous literature [6,11].…”

Section: Discussionmentioning

confidence: 65%

Aripiprazole as a treatment option for delusional parasitosis: case series of 8 patients

Çınar

Kutlutürk

Ertek

et al. 2019

Psychiatry and Clinical Psychopharmacology

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“…The duration of the disease ranges from months to years (34). The most affected organ is the skin but other parts of the body can be affected as well (21,35).…”

Section: Drugs or Conditionsmentioning

confidence: 99%

Delusional infestation. Ekbom´s syndrome in a 47-year-old woman. Case report

Olivera¹,

Villamil²,

Moreno³

et al. 2017

Case reports

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Introduction: Delusional infestation is a rare psychiatric disorder defined as a condition in which the patient has the unshakable belief and perception of being infested with parasites. Its treatment is difficult, and frequently includes antipsychotic medications (such as olanzapine or aripiprazole). Non-pharmacological treatment, particularly psychotherapy, can be used for less severe cases. Dermatologists and psychiatrists must take a multi-disciplinary approach (preferably in a psycodermatology dedicated clinic) since this type of patients sometimes refuse treatment. Case description:A 53-year-old female businesswoman describes a clinical history of five years of visual hallucinations, depressive symptoms, and generalized pruritus, along with the use of toxic substances to "clean" her skin and cloths. She reports similar symptoms in some relatives but they were not evaluated. Blood tests and analyses of the "specimen" brought by the patient were performed, yielding negative results. The patient had never been assessed by any specialist, and showed disoriented during the consultation. Follow-up was not possible due to the reluctance of the patient to follow the indications and seek psychiatric treatment. Moreover, the patient did not respond to further communication attempts.

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“…He claimed that much of the skin debris he had extracted from the lesion represented the organisms. Psychiatric examination established the diagnosis of self‐injury secondary to delusional infestation . Control of pathological ideation was obtained with the introduction of olanzapine 10 mg per day .…”

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confidence: 99%

Extensive scalp ulcer secondary to delusional infestation treated with antipsychotics and scalp reconstruction

et al. 2020

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Delusional infestation: a case series from a university dermatology center in São Paulo, Brazil

Abstract: Delusional infestation is an extremely chronic disease. Attempts to discontinue treatment in those patients in whom a lengthy follow-up was performed inevitably resulted in symptom relapses.

Cited by 20 publications

References 16 publications

Aripiprazole as a treatment option for delusional parasitosis: case series of 8 patients

Aripiprazole as a treatment option for delusional parasitosis: case series of 8 patients

Delusional infestation. Ekbom´s syndrome in a 47-year-old woman. Case report

Extensive scalp ulcer secondary to delusional infestation treated with antipsychotics and scalp reconstruction

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