Delusions of parasitosis; suggested dialogue between dermatologist and patient

Abstract

Delusions of parasitosis (DoP) is a psychocutaneous condition characterized by a fixed false belief that one is infested by skin parasites. Patients afflicted with DoP generally experience sensations of biting, stinging or crawling in the absence of any objective evidence of infestation. The most definitive treatment for DoP is antipsychotic agents. Though the diagnosis and treatment options are rather straightforward, the difficulty lies in the art of building a therapeutic rapport with the patient in order to encourage acceptance of antipsychotic treatment. This article is a practical guide that suggests verbatim how dermatologists might talk to a delusional patient in order to establish a strong therapeutic rapport. Strategies on how to optimize the initial encounter, build rapport and prescribe antipsychotic medications that are likely to be accepted by the patient are discussed.

• Delusions
• dialogue
• infestation
• parasitosis
• psychodermatology

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Dr. J. Y. M. K. is a speaker for Abbvie and serves as a principle investigator for clinical trials sponsored by Janssen and Amgen. Dr. Koo has no stocks, employment or board membership with any pharmaceutical company. There is no pharmaceutical sponsorship involved in the publication of this article.