The plague: a case of delusional infestation with folie à deux / A praga: um caso de delírio de infestação com folie à deux

Folie à deux or Shared psychotic disorder (SPD) is a rare condition characterized by shared psychotic symptoms between two or more individuals. Delusional parasitosis (DP) is an uncommon psychiatric illness in that patients believe they are infested by insects, without evidence to support this belief. DP occurs in 5­15% of SPD. We report a case of cutaneous DP with SPD between an elderly mother and a daughter that lived together and withdrew from other social contacts for the last three years. We aim to highlight the relationship between SPD and DP, its prognosis, and clinical implications.

Folie à deux ou Perturbação Psicótica Compartilhada (PPC) é uma condição rara caracterizada por sintomas psicóticos compartilhados entre dois ou mais indivíduos. O delírio parasitário (DP) é uma doença psiquiátrica incomum em que os pacientes acreditam estar infestados por insetos, sem evidências que sustentem essa crença. O DP ocorre em 5 a 15% das PPC. Relatamos um caso de um DP cutâneo com PPC entre uma mãe idosa e uma filha que viviam juntas e afastadas de outros contatos sociais nos últimos três anos. O nosso objetivo é destacar a relação entre PPC e o DP, o seu prognóstico e implicações clínicas

Ekbom Syndrome associated with Lewy Body Dementia: A case report / Síndrome de ekbom associada à demência com corpos de lewy: um relato de caso

ABSTRACT Ekbom Syndrome, also known as parasitosis delusion or psychogenic parasitosis, is a rare condition in which patients present with a fixed belief of being infested by parasites, vermin or small insects, along with tactile hallucinations (such as pruritus or sensations of the parasites crawling over or under the skin). The syndrome may occur idiopathically or be associated with other medical conditions and drug use. This case report describes the occurrence of Ekbom syndrome in a patient diagnosed with Lewy Body Dementia (LBD), a neurodegenerative disease that commonly presents with sensory perception and thought disorders and other neuropsychiatric symptoms. Although visual hallucination is considered a core diagnostic criterion, other modalities of psychiatric symptoms can also occur posing a further challenge for correct diagnosis. Proper recognition allows early diagnosis and adequate treatment, preventing hazardous antipsychotic use in these patients.

RESUMO A síndrome de Ekbom, também conhecida como delírio parasitário ou parasitose psicogênica, é uma condição rara na qual os pacientes apresentam crença fixa de estarem infestados por parasitas, vermes ou insetos, acompanhada de alucinações táteis (como prurido ou sensação dos parasitas andando sobre ou sob a pele). A síndrome pode ocorrer de forma idiopática ou associada a outras condições médicas ou uso de drogas. Este relato de caso descreve a ocorrência da síndrome de Ekbom em um paciente diagnosticado com Demência com corpos de Lewy (DCL), uma doença degenerativa que comumente se apresenta com desordens de sensopercepção e pensamento, e outros sintomas neuropsiquiátricos. A alucinação visual é considerada um dos critérios diagnósticos nucleares, entretanto outras modalidades de sintomas psiquiátricos podem ocorrer criando desafios adicionais ao diagnóstico correto. O reconhecimento apropriado permite o diagnóstico precoce e tratamento adequado, prevenindo o uso arriscado de antipsicóticos nesses pacientes.

Delusional Parasitosis in a Patient with an Infarction in the Territory of the Right Posterior Cerebral Artery

No abstract available.

Delusional infestation. ekbom's syndrome in a 53-year old woman. case report

ABSTRACT 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. Discussion: Delusional infestation is an uncommon disease that endangers the patients and the people around them. Its treatment is difficult and long, and not conducting proper follow-up is a great risk. Its prevalence and incidence is variable and generally unknown. It can affect the patient, their next of kin, pets or the environment, and the "pathogen" can be a living organism or an inanimate object. Conclusion: This case is important as it shows the hardships of treatment, adequate follow-up and care, as well as the need to improve how these patients are approached. Additionally, both classical and uncommon signs and symptoms could be observed as the patient stated that her relatives were affected (possible delusional infestation by proxy).

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.

Atypical case of Delusional Parasitosis in Genital area.

A patient with delusional parasitosis of genital area, who responded to amisulpride is described.

Ekbom Syndrome.

A patient with Ekbom Syndrome with Leprosy, who responded to Amisulpride is described.

Delusional Parasitosis.

A patient with delusional parasitosis, who responded to amisulpride is described.