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PESTNOTES Publication 7443University of California

Agriculture and Natural Resources Revised August 2003

DELUSORYPARASITOSIS:

WHATSATTACKINGME?

The sensation feels likebugs, worms, or mitesthat are biting, crawlingover or burrowing into,under, or out of yourskin. They must bethere, because you can

feel them and you are even pretty surethat you can see them. You may also

believe that your home or furniture isinfested, but you may be the only onewho knows they are there. No oneseems to think they exist except you.

Nothing seems to get rid of them. Sowhat are they?

And, what if your condition seems to bespreading to other family members orto your friends? What if, after tryingevery reasonable approach and helpfulhint from friends, your problem per-sists? Then its time to read the rest ofthis publication and seek the propertype of professional help.

Who can help you resolve this sort ofproblem? The first person to contact

should be your family physician orprimary health care provider. Medicalprofessionals are the only individualswho are licensed to diagnose your con-dition and recommend specific treat-ments. Dermatologists, in particular,are trained to deal most effectively withdisorders of the skin and their causes,including parasites. If the disorder iscaused by a parasite, most physicianscan recognize the most common para-sites. If necessary, medical specimenscan be submitted by the physician toentomologists, parasitologists, or other

biologists for verification or identifica-tion. These narrowly focused expertsnot only can identify or rule out various

kinds of parasites that may be causingyour condition, but they can provideadditional biological information thatmay greatly assist your physician andyou in arriving at a satisfactory diagno-sis and treatment. Most entomologistsare skilled in the identification of vari-ous life stages of insects or mites andcan use the correct references to deter-mine what they are. Medical entomolo-gists, in particular, spend their careersworking with insects, mites, and ticksthat attack people. Parasitologists study

these and other groups of organismssuch as parasitic worms, protozoans,and other invertebrates that live at theexpense of their animal hosts.

Initially, you may have tried to solvethe problem by consulting nonmedicalprofessionals. However, if you do notseek professional medical advice, youmay miss the opportunity to be prop-erly diagnosed, especially if arthropodsor other parasites are not the culprits. Ifyou have consulted with any, or per-haps several, of the above mentioned

professionals and still no one can pin-point an offending organism, it is veryunlikely that all of them are wrong. It istime to reassess your situation and lookfor a cause other than a pest organism.Itching, crawling, or burrowing sensa-tions may be the result of many unre-lated medical conditions, including stress reactions to use, or abuse, of prescrip-

tion or illicit drugs allergic sensitivity to nonliving sub-

stances in your environment (officepaper dust is a well-known example)

dry skin mechanical irritants, such as fiber-

glass filaments

skin cancers vitamin, protein, or other deficiencies

in your diet diabetes mellitus cerebrovascular disease hypothyroidism delusory parasitosis.

Thorough testing, including a completephysical checkup by a perceptive physi-cian, should lead to an accurate diagno-sis and treatment for most sensations ofinfestation caused by metabolic disor-

ders or other medical problems listedabove. If samples are required, theyshould be taken directly by the physi-cian and submitted to the experts, ifnecessary. If a physical and/or thor-ough allergy and medical testing leaveyou with a clean bill of health, andthe symptoms still persist, you have toconsider seriously the possibility thatyou may be mistaken in your belief thatyou are infested with some sort of ar-thropod or other parasite.

The medical disorder in which a patient

has a mistaken belief of being infestedby parasites such as mites, lice, fleas,spiders, worms, bacteria, or other or-ganisms is called delusory parasitosis.This belief is based on the sensationsfelt in the skin that are very real to thesufferer. These sensations of irritation,itching, or of crawling organisms are soreal that the victim is driven to believethat something has to be there. Usually,the patient scratches the itches, but theydont go away. More scratching leads torashes, open wounds and sores, then topossible infections. Failure to obtainrelief from over-the-counter or pre-scribed medications often drives thesufferer to apply unconventional and

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7/27/2019 (psychology, self-help) Delusory Parasitosis - What's Attacking Me.pdf

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August 2003 Delusory Parasitosis

For more information contact the University

of California Cooperative Extension or agri-cultural commissioners office in your coun-

ty. See your phone book for addresses andphone numbers.

AUTHORS: R. B. Kimsey and E. C. Mussen

EDITOR: B. Ohlendorf

TECHNICAL EDITOR: M. L. Flint

DESIGN & PRODUCTION: M. Brush

Produced by IPM Education and Publica-

tions, UC Statewide IPM Program, Universi-

ty of California, Davis, CA 95616-8620

This Pest Note is available on the World

Wide Web (http://www.ipm.ucdavis.edu)

This publication has been anonymously peer re-viewed for technical accuracy by University of Cal-ifornia scientists and other qualified professionals.This review process was managed by the ANR

Associate Editor for Pest Management.

To simplify information, trade names of productshave been used. No endorsement of named productsis intended, nor is criticism implied of similar productsthat are not mentioned.

This material is partially based upon worksupported by the Extension Service, U.S. Departmentof Agriculture, under special project Section 3(d),Integrated Pest Management.

The University of California prohibits discrimination against or harassment of any person employed by orseeking employment with the University on the basis of race, color, national origin, religion, sex, physicalor mental disability, medical condition (cancer-related or genetic characteristics), ancestry, marital status,age, sexual orientation, citizenship, or status as a covered veteran (covered veterans are special disabledveterans, recently separated veterans, Vietnam-era veterans, or any other veterans who served on activeduty during a war or in a campaign or expedition for which a campaign badge has been authorized).University policy is intended to be consistent with the provisions of applicable State and Federal laws.Inquiries regarding the Universitys equal employment opportunity policies may be directed to theAffirmative Action/Staf f Personnel Services Director, University of California, Agriculture and NaturalResources, 300 Lakeside Drive, 6 th Floor, Oakland, CA 94612-3550, (510) 987-0096.

sometimes highly toxic compounds tothe body in a desperate attempt to alle-viate symptoms. Skin conditions canworsen or become much morecomplicated.

In some cases the parasites appear to bevisible to the afflicted person, but theycannot be caught. In a desperate at-tempt to discover the causative agent,some will submit pieces of his or herown tissue to medical or other profes-sionals in an attempt to producesamples of the pests. Such wounds can

become serious medical problems.

Very often a corollary problem associ-ated with or causing delusory parasito-sis is stress. Stress often manifests itselfin people as a nervous habit or nerv-ous tic, but those conditions usuallyare not overwhelming. Delusory parasi-tosis, however, can become debilitating

because it tends to amplify the stresslevel and, in turn, the condition worsens.

Stress is known to be associated withmany health problems in Americans.

Stress may result from numerous expe-riences including job-related pressures,personal relationships, divorce, loneli-ness, financial problems, and loss offriends, relatives, or pets. Frequently,reducing or learning to deal with stress

coincides with a rapid reduction orelimination of delusory parasitosis.

Your doctor usually can assist in find-ing ways to reduce your level of stress.However, when delusory parasitosis ispersistent, your physician may want toprescribe medicines that alleviatesymptoms, at least temporarily, whilemore permanent solutions are sought. Ifyour physician determines that furthertherapy or advice is needed, then youmay be referred to a psychiatrist. Psy-chiatrists may prescribe compoundsthat can successfully treat this disorder.Delusory parasitosis is real, and withprofessional help it can be medicallymanaged or eliminated altogether.

More information on delusory parasito-sis may be obtained from professionalsworking in county health services of-fices, University of California Coopera-tive Extension offices, from countyagricultural commissioners, or from theBohart Museum of Entomology, Uni-versity of California, Davis Web site:http://delusion.ucdavis.edu/. Tele-phone listings for these offices are in theGovernment Pages, subsection CountyGovernment Offices, of local telephonedirectories.

REFERENCES

Berrios, G. E. 1985. Delusional parasito-sis and physical disease. ComprehensivePsychiatry 26:395403.

Damiani, J. T., F. P. Flowers, and D. K.Pierce. 1990. Pimozide in delusions ofparasitosis.J. Amer. Acad. Dermatol.

22(2):312313.

Grace, J. K., and D. L. Wood. 1987.Delusory cleptoparasitosis: delusions ofarthropod infestations in the home.Pan-Pacific Entomol. 63(1):14.

Koblenzer, C. S. 1993. The clinical pre-

sentation, diagnosis and treatment ofdelusions of parasitosisa dermatologicperspective. Bull. Soc. Vector Ecol.18(1):610.

Lyell, A. 1985. Delusions of parasitosis.In M. Orkin and H. I. Maibach, eds.Cutaneous Infestations and Insect Bites.New York: Marcel Decker, Inc. pp. 131137.

Macaskill, N. D. 1987. Delusion parasi-tosis: successful non-pharmacologicaltreatment of folie-a-deux. Brit. J. Psy-chiatry 150:261-263.

Marshall, M. A., R. F. Dolezal, M.Cohen, and S. F. Marshall. 1991.Chronic wounds and delusions of para-sitosis in the drug abuser. Plast.Reconstr. Surg. 88(2):328-330.

Musalek, M., and E. Kutzer. 1990. Thefrequency of shared delusions in delu-sions of infestation. European Archives ofPsychiatry and Neurological Sciences239(4):263-266.

Musalek, M., M. Bach, K. Gerstberger, O.M. Lesch, V. Passweg, J. Wacata, and H.Walter. 1989. Drug therapy of delusionalparasitosis. The importance of differen-tial diagnosis for psychopharmacologictreatment of patients with delusionalparasitosis. Wiener MedizinischeWochenschrift 139(13):297302.

Webb, J. P., Jr. 1993. Case histories ofindividuals with delusions of parasito-sis in southern California and a pro-posed protocol for initiating effectivemedical assistance. Bull. Soc. Vector Ecol.

18(1):1625.