Ekbom's Syndrome: a Case Report

Abstract

Introduction

Delusional parasitosis (DP) is a disorder in which the patient believes that he is infested by a parasite. Although this is a psychiatric disorder, patients usually seek care from dermatologists. A dermatology-psychiatry liaison is advocated for establishing a viable differential diagnosis and selecting appropriate therapy.

Objectives

To review the literature through a case report.

Aims

To highlight the incidence, the causes, the typical characteristics of patients with DP, the best approach when dealing with a patient with DP

Methods

Case report.

Results

A 75 year-old widow was referred to the outpatient psychiatric department of Razi Hospital by a dermatologist because of hyperchromic pruritic skin lesions in arms. The illness began 2 years ago, after the death of her husband, with itching sensations on her arms that the patient attributed to “bugs” under her skin. She used to put the 'animals” in a piece of paper to prove their existence. She tried various strategies for eradicating the alleged parasites, such as using pesticides on herself and her possessions. Risperidone was started up to 3mg per day. She had a progressive clinical improvement.

Conclusions

Ekbom’s syndrome is a delusion of hallucinatory mechanism that might have different cultural presentations and could be favored by social vulnerability. The typical patient is an elderly woman who is unmarried or living along. Rather than a unique illness, DP is a neuropsychiatric syndrome that can follow primary psychotic and depressive disorders, dementia or other organic diseases. Treatment is based on antipsychotic agents, psychotherapy and cooperation between dermatologists and psychiatrists.