Delusions of parasitosis.
BACKGROUND
Delusions of parasitosis (DP) is a rare psychiatric disorder in which the patient has a firm belief that she or he is infected by parasites. Although it is a psychiatric disorder, these patients often present to an emergency physician because they are convinced that they have a severe skin problem.


METHODS
Patients with DP often reject psychiatric referral. The diagnosis of DP can usually be made based on history alone. However, it is important that the patient does not have an organic skin disorder and that the delusion is not secondary to another mental or physical illness. The current treatments of choice are the antipsychotic medications risperidone and olanzapine.


CONCLUSIONS
In our experience, patients with DP seen in the emergency department who are suspected of having this condition can be a challenging diagnostic and treatment problem because they usually do not have health insurance. Consequently, we find it difficult to get dermatologic and psychiatric consultation to treat their illness.
Legacy Verified Level I Shock Trauma Center for Pediatrics and Adults, Legacy Emanuel Hospital, Portland, OR 97227, USA. richardedlichmd@gmail.com
Richard F
RF
Edlich
Catherine L
CL
Cross
Courtney A
CA
Wack
William B
WB
Long
D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D003702:Delusions / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D004636:Emergency Service, Hospital; D006801:Humans; D019458:Insurance Coverage; D000077152:Olanzapine; D010272:Parasitic Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D012017:Referral and Consultation; D016079:Refusal to Treat; D018967:Risperidone / Q000627:therapeutic use
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine