Self inflicted corneal abrasions due to delusional parasitosis

Meraj, Adeel; Din, Amad U.; Larsen, Lynn; Liskow, Barry

doi:10.1136/bcr.04.2011.4106

Cited by 13 publications

(8 citation statements)

References 18 publications

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“…16 , 17 There are also reports of corneal abrasions, lacerations, fungal infections, and vision loss resulting from patients attempting to eradicate the infesting organisms. 19 – 21 In the case of our patient, there was no significant periorbital skin trauma; however, his history of pustule formation and skin ulceration, as well as the inferior bulbar conjunctival punctate erosions, could be consistent with psychosomatic self-inflicted trauma.…”

Section: Discussionmentioning

confidence: 55%

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Delusional infestation: are you being bugged?

Thakkar¹,

Ooi²,

Assaad³

et al. 2015

OPTH

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This case report documents a 58-year-old male who presented to the clinic with a 12-month history of a burrowing sensation in his eyelids that he attributed to a parasitic infestation. After being extensively investigated and reviewed by relevant specialties, no evidence of parasitic infestation was found. He was diagnosed with and treated for blepharitis. Psychiatric referral for presumed delusional infestation (DI) was recommended. Despite this, he remained insistent in his belief of infestation, and was inevitably lost to follow-up. DI, previously known as delusional parasitosis, is a rare delusional disorder where affected individuals have a fixed, false belief that they have a parasitic infestation. Diagnosis can be challenging. Practitioners need to evaluate between primary and secondary DI carefully, as management differs depending on the etiology. Despite this, patients diagnosed with primary DI tend to be resistant to psychiatric referral. This report aims to optimize management by giving the reader a guideline for appropriate investigations and advice on patient approach. It is important to recognize hallmark features of DI to minimize self-inflicted trauma and associated psychosocial consequences. Effective treatment for DI is available, and devastating consequences, including blindness, can be avoided.

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Section: Discussionmentioning

confidence: 55%

“…He later agreed to be treated with olanzapine. 19 This stresses the importance of developing a therapeutic connection, and even in some cases conceding that the symptoms and even the infestations are real in order to facilitate treatment.…”

Section: Discussionmentioning

confidence: 99%

Delusional infestation: are you being bugged?

Thakkar¹,

Ooi²,

Assaad³

et al. 2015

OPTH

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“…Although a typical antipsychotic, pimozide has been used formerly as the first-line option in the treatment of DP, current treatment algorithms proposes the atypical antipsychotics as first order options [2,5,6,[16][17][18]. Among those most commonly used atypical antipsychotics, partial (72%) or full remission (69%) has been reported with risperidone and olanzapine [16].…”

Section: Discussionmentioning

confidence: 99%

Delusional parasitosis presenting as Folie a Famille'': case report

Zincir¹,

Karakoç²,

Zincir³

2014

J Behav Health

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Delusional parasitosis (DP), which is also known as Ekbom syndrome, is a rare delusional disorder where the patient is convinced of being infested with worms, insects, parasites or bacteria, while no objective evident exist to support this belief. Because patients believe that the disorder is due to the physical cause, they usually apply dermatologists or family practitioners for treatment at first, and referred to psychiatrists after their symptoms become more prominent. Somatic delusion is shared with one or more members of a family (folie a deux-trois) or by all members of the family ("folie a familie") in 5-15% of DP cases. Today, second generation (atypical) anti-psychotics are used in the treatment. In this paper, a primary case of DP presenting as shared psychotic disorder (SPD) in the form of "folie a famille," clinical picture and treatment process is presented. We used olanzapine for treatment of primary case. Her symptoms ceased within 3 months and other family members became asymptomatic without any medication. She was still asymptomatic at the end of 4 months. This case report is important in terms of showing psychosocial impact of DP and SPD comorbidity and to create awareness about this disease among health care providers.

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“…The most affected organ is the skin but other parts of the body can be affected as well (21,35). For its diagnosis, delusion must have a duration of at least 1 month, but patients must remain highly functional (1) and present with two main symptoms: 1) the strong belief of being infested despite medical evidence shows otherwise (100% of the patients), and 2) abnormal sensations as if an infectious agents caused them (88%) (6,36,37).…”

Section: Drugs or Conditionsmentioning

confidence: 99%

“…This condition can be affected by a large array of complications as listed in Table 3 (6,12,35). The recommended treatments are based on anti-psychotic medication such as risperidone, pimozide (36,46), olanzapine, amilsupride, quetiapine and aripiprazole (47)(48)(49)(50).…”

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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Self inflicted corneal abrasions due to delusional parasitosis

Cited by 13 publications

References 18 publications

Delusional infestation: are you being bugged?

Delusional infestation: are you being bugged?

Delusional parasitosis presenting as Folie a Famille'': case report

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

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Self inflicted corneal abrasions due to delusional parasitosis

Cited by 13 publications

References 18 publications

Delusional infestation: are you being bugged?

Delusional infestation: are you being bugged?

Delusional parasitosis presenting as &#145;&#145;Folie a Famille'': case report

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

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Delusional parasitosis presenting as Folie a Famille'': case report