Dermatozoa delusion is when the affected person believes that he or she is infested with parasites such as insects under the skin. However, these exist only in his imagination.
What is dermatozoa delusion?
Dermatozoa delusion is one of the delusions and is also considered an organic psychosis. In this mental illness, the affected individuals are absolutely convinced that there are insects or worms under their skin, which they can clearly feel by their movements. This, in turn, causes patients to experience anxiety or physical symptoms such as itching. However, clinical evidence of parasite infestation cannot be found during medical examinations, so the supposed invaders are only in the patients’ imagination. Dermatozoan mania is also known as skin-animal mania, insect mania, acarophobia, parasitophobia, or delusional vermin infestation. The term was coined by Swedish neurologist Karl-Axel Ekbom (1907-1977), who described the disorder in 1938. For this reason, dermatozoa mania also bears the name Ekbom syndrome. A typical feature of dermatozoa delusion is the fact that even all medical examination results cannot convince the patient of his error. Thus, he is of the firm opinion to be infested by parasites and suffers terrible agonies as a result. Some sufferers even believe they can see the insects and collect supposed “evidence” such as skin particles, skin flakes, fibers from textiles or dust grains to present to doctors, relatives or friends. Exact figures on how many people suffer from dermatozoa mania are not available. The reason for this is also that the patients do not go to a psychologist or a neurologist, but rather to dermatologists or entomologists. For this reason, there are only a few psychiatric writings on this form of delusion. What is known, after all, is that predominantly women between the ages of 50 and 70 are affected by this mental disorder.
Causes
The causes of a dermatozoa delusion turn out differently. In addition to physically justifiable psychoses such as organically caused mental illness, endogenous psychoses, which include schizophrenia, for example, can also be considered as triggers for the delusions. But also purely mental or psychosocial components can cause a dermatozoic delusion. In the case of hallucinations, faulty signal transmissions occur. These mostly result from disturbances in the dopaminergic system within the central nervous system (CNS). Therefore, the perception of the body is not perceived as normal and the affected person cannot distinguish between reality and delusions. Therefore, she firmly believes in the phenomena that determine her perception. In addition, there is a disturbance of tactile consciousness, which also affects the perception of pain. However, the reasons for the disturbance of the dopaminergic system have not yet been clarified. Sometimes drug withdrawal is also considered to be a trigger of dermatozoic mania. In addition, hallucinations are often preceded by the abuse of alcohol, amphetamines or cocaine. But also injuries of the brain are considered as conceivable triggers. In medicine, a distinction is made between a primary and a secondary dermatozoa delusion. The primary form has no visible physical or psychological causes. This pure dermatozoa delusion is basically a delusional disorder. Various dermatologic, internal, or neurologic diseases, as well as psychiatric disorders, are responsible for the secondary form.
Symptoms, complaints, and signs
Affected individuals first notice a dermatozoa delusion by skin sensory disturbances. In doing so, they perceive parasites under their skin in their imagination, but they are not present at all. As it progresses, the delusional disorder solidifies and becomes systematic. External observers cannot recognize anything unusual in the patient. However, the affected person himself feels clear discomfort such as itching and even pain. These symptoms come from the supposedly free-roaming insects. Because patients are constantly scratching themselves, this leads to real damage to the skin over time.
Diagnosis
Diagnosing a dermatozoa delusion is often not easy, as affected individuals are more likely to turn to a dermatologist than a psychiatrist.The dermatologist performs a thorough physical examination of the patient, which, however, usually remains inconclusive. If the suffering intensifies, it is advisable to consult a psychiatrist, which, however, is categorically rejected by most of those affected. Thus, the patients believe that they would be considered “crazy” or mentally ill. An important role in the diagnosis is also played by the differentiation from other mental illnesses such as an ego disorder or schizophrenia. The course of dermatozoa mania is difficult because patients do not cooperate with doctors. Instead, they gather supposed evidence to support their theories about the illness.
Complications
In dermatozoa delusions, the main complications are psychological, which can have a very negative impact on the patient’s daily life. In most cases, the patient also tells other people that he or she is infested with parasites and insects. This can seem bizarre and incomprehensible to other people, which can lead to social problems. Social exclusion often occurs, further exacerbating the symptom. At first, the disorder occurs only under the skin and leads to a feeling of being infested with parasites. Due to this feeling, the daily life of the affected person is limited. Patients feel tired and exhausted and suffer from strong delusions. It is no longer possible to lead a regular and ordinary everyday life. Often the patient also feels pain and itching on the skin. However, these do not really exist. This delusion causes scratching of the skin, which can result in wounds and scars. This causes lasting damage to the skin. In the worst case, suicidal thoughts occur. Treatment rarely leads to success, as the patient usually cannot be convinced to suffer from the dermatozoa delusion.
When should one go to the doctor?
If sensory disturbances are suddenly noted on the skin that do not appear to have an identifiable cause, a dermatozoa delusion may be present. The delusional disorder is initially manifested by mild sensory disturbances that quickly develop into full-blown but imagined complaints. Anyone who suspects such a disorder in themselves or others should consult a psychiatrist. Initially, a family doctor can clarify the complaints and thus show the affected person that it is an imaginary condition. Since sufferers are usually firmly convinced that the sensations are real, a trusted person should be consulted if possible. People suffering from schizophrenic disorder are particularly susceptible to disorders such as dermatozoa delusions. They should talk to the responsible therapist or a relative if they experience unusual symptoms. If necessary, the relatives themselves must arrange for psychological counseling. The sufferer needs permanent support afterwards and should also talk to a doctor regularly with regard to possible schizophrenia.
Treatment and therapy
The therapy of dermatozoa mania is also not easy. Thus, patients do not believe in a mental disorder. It is not uncommon for those affected to break off contact with the specialist and undergo their own treatments, which are sometimes even dangerous. In addition, the dermatocenic delusion is considered to be almost impossible to influence. In extreme cases, patients react so desperately that they attempt suicide. If there is a clear diagnosis of dermatozoa mania, drug therapy with neuroleptics is carried out. In most cases, agents such as risperidone, haloperidol and pimozide are used. To date, however, few studies exist on the efficacy of these agents.
Outlook and prognosis
The prognosis of dermatozoa delirium depends on several factors. A disease course that is affected by the delusion for only a short period of time is considered favorable. If the underlying primary disease can be found and cured, there is also a good chance of recovery. Overall, the prognosis is very much tied to the patient’s willingness to cooperate and reliability. If these conditions are met, complete or partial remission of the disease may occur. In unfavorable cases, dermatozoa delirium takes a chronic course and is not considered treatable. Patients with this course of the disease have a considerable impairment due to the complaints in everyday life. In addition, there is an increased risk of suicide.A good prognosis is given in about half of the patients. Sufferers seek medical attention when they experience symptoms and accept the diagnosis. In addition, they respond well to the treatment plan and show a high willingness to work with a therapist to address the causes. They are often treated through psychotherapy in conjunction with medication. The healing process can take several years, depending on the cause. Complete freedom from symptoms is possible, but must be evaluated individually.
Prevention
Meaningful measures for the prevention of dermatozoic mania do not yet exist. For example, the exact triggers of the mental disorder have not yet been adequately clarified.
Follow-up
Because a dermatozoan mania is usually relatively difficult to treat, the measures or options for aftercare are also very limited. In this regard, the affected person is primarily dependent on a quick and direct treatment of this disease to prevent further discomfort and complications. Since self-healing is usually not possible, the main priority in this disease is an early diagnosis with subsequent treatment. In the case of dermatozoa delirium, it is also important that the friends and relatives of the affected person deal with the disease and deal with it. They should support the affected person during the treatment and help him with the disease. The treatment itself is carried out with the help of a psychologist. Most of those affected also rely on taking medication. Here, care must be taken to ensure that the medication is taken regularly and also in the correct dosage in order to provide lasting relief from the symptoms. In severe cases, the relatives can also persuade the person affected with dermatozoa mania to undergo treatment in a closed clinic. In most cases, this disease does not reduce the life expectancy of the affected person.
This is what you can do yourself
Dermatozoa delirium is a serious mental illness that should be treated by a skilled therapist. Unfortunately, most patients drop out of psychotherapy because they do not consider themselves to be mentally ill. Here the help of family members, friends or acquaintances is very important. If the patient is willing to undergo therapy, he or she can also do something in everyday life to facilitate the way out of this illness. In order to make it clear to the patient that he or she is not suffering from a parasite infestation, a stool examination could help. This would prove that the patient is healthy, because if the skin were infested with parasites, these would also be found in the intestines. Parasites spread rapidly throughout the body. To counteract the constant itching, cooling ointments or gel, for example from aloe vera, help. Antiseptic and anti-inflammatory ointments should be used on open skin areas and wounds. Preventive use of greasy creams (Linola) or lotions containing urea can also alleviate the symptoms. If the accompanying depression is very severe and suicidal thoughts occur, medication should be used (antidepressants, neuroleptics). Relatives and acquaintances can support the affected person by not letting self-imposed isolation prevent them from visiting regularly. Maintaining social contacts is fundamentally important.