What Is Delusional Parasitosis?

What Is Delusional Parasitosis?

Delusional parasitosis is a rare condition in which the person holds the delusional belief that they are infested with parasites. The condition is also known as Ekbom’s Syndrome, named for the Swedish neurologist Karl Alex Ekbom who published the first records of the disease in 1937 and 1938.

The name can be a source of confusion as Dr. Ekbom was also among the first to study restless leg syndrome. That condition also bears his name: Wittmaarck-Ekbom. The two conditions are in no way similar, however. Restless leg is a condition with physical causes while delusional parasitosis is a psychological condition. Some, referring to restless leg syndrome, will shorten its title to “Ekbom syndrome,” leaving the well-informed listener or reader to discern which disease is being referenced simply by the context of the conversation.

Signs of Delusional Parasitosis

Sufferers of delusional parasitosis claim that parasites are crowded just beneath their skin. They also believe that the parasites are in and around their body cavities and perhaps in their stomachs or bowels. They feel they are literally infested with parasites.

The person may report “formication,” which is the medical term for the sensation of crawling on the skin. This crawling sensation may also be described as, or compared to, the “pins and needles” feeling experienced when circulation is cut off from a body extremity such as the foot or hand. This crawling sensation may lead the sufferer to scratch themselves excessively, possibly to the point of self-injury.

Some people suffering from delusional parasitosis may be convinced that not only their body, but also their clothing, their home and other surroundings are also infested by the parasites. Their belief in the swarm of parasites all around may be determined enough to convince others close to them that they also have been infested. A variation of the condition is called delusory cleptoparasitosis, in which the person does not believe themselves to be infested, but only their place of habitation.

Sufferers who seek treatment from a dermatologist or their family physician may show up at the office with samples for the doctor to examine. The “evidence” could be tiny patches of skin, minute particles of dust or other substances encased in an envelope or a matchbox. For this reason, it is referred to as the “matchbox sign.”

Causes & Treatment

Although rare, delusional parasitosis can be associated with a neurological disorder or disease. More often, it is associated with drug use. Abuse of stimulants such as amphetamines and cocaine can produce the delusions. This effect from cocaine abuse has been referred to as “cocaine bugs.”

When the delusion is a chronic condition, it may be treated similarly to schizophrenia or other delusional disorders with antipsychotic medication. Pimozide has been the drug of choice to date. In instances where the delusion is temporary and associated with drug abuse, the treatment focuses on cessation of drug use and drug rehabilitation.

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