I was 45 when I first noticed my symptoms. It was an allergy to the scalp and back. I felt a terrible itch. I couldn’t stop scratching myself. I bought various types of ointments at the pharmacy, but there was no improvement. Finally, I went to the allergist who did the allergy tests. They were all negative.
The pruritus was getting so bad that it often woke me up during the night. Then I noticed small, hard bumps on my scalp. I was horrified. But the worst was when worms hatched from the nodules and began to crawl under the scalp. I panicked. I started washing my hair several times a day and combing the worms with a comb. The itching was getting more and more severe. I couldn’t really stop scratching anymore. Eventually I figured it must be some kind of parasite. And I went to the pharmacy again. I bought a lice liquid. I started applying it several times a day and then combed the worms out of my head as thoroughly as possible. Unfortunately, I did not feel any improvement. I even woke up at night. I scratched my head so badly that my blood often ran out. But even then I didn’t stop. I was scratching my wounds deeper and deeper, because I knew that they were there. After a dozen or so weeks, it turned out that the worms took over my whole body, that they were everywhere, on my legs, arms and face. I was scratching, but it wasn’t just scratching. I wanted to scratch off all my skin. I felt them crawling inside me, how unpunished they are, and I couldn’t reach them. Finally, I reached for the knife to make small cuts in the skin and finally pull them out. With no effect. Each time the cuts were too shallow. And they writhed under my skin, driving me crazy. I was afraid to leave the house so as not to infect other people. I isolated myself from my relatives and friends. – This is how Marta from Warsaw describes her story.
There are many such cases. And although they may have a different clinical course and severity of symptoms, they have one thing in common – an irrational fear of parasites living under the skin. This disorder was initially thought of as a type of phobia and called parasitophobia. With time, however, scientists decided that the name was not appropriate because the disease was delusional. The current term today is parasitic insanity, also known as tactile hallucinosis.
Who is at risk?
Parasitic madness most often develops on the basis of organic damage to the central nervous system. It is diagnosed as delusional disorder or hypochondriacal psychosis with one symptom. It can also appear in the course of organic disorders, schizophrenia and affective disorders that may be accompanied by depression.
Affected people are convinced that microscopic parasites that cannot be observed live and multiply under their skin. Single women, who live in isolation, often in old age, are most exposed to the occurrence of parasitic insanity. The appearance of similar symptoms in young people may be a signal of their use of intoxicants such as drugs (the so-called cocaine worms). Risk factors are also low socioeconomic status and low education.
People suffering from parasitic insanity are also characterized by a lack of criticism towards the reported symptoms. Often, patients who want to prove that worms have taken over their bodies present evidence in the form of skin fragments or exfoliated epidermis, or parts of the body of some insects allegedly removed from the skin. Most often they claim to be infected with insects, spiders, dragonflies or fleas. They also report symptoms such as itching and other somatic symptoms.
Washing and cleaning rituals aimed at removing parasites from the body are common among those affected by parasitic insanity. Patients often isolate themselves from the environment, which is associated with the fear of infecting other people.
Treatment of the disorder
In the case of people suffering from delusions of parasitic skin disease, psychiatric treatment is necessary, although patients rarely seek help.
They often visit a dermatologist’s office expecting him to treat their parasitic disease. However, after exclusion of scabies and allergies, the doctor refers the patient to a psychiatrist, and eventually treats secondary skin lesions caused by the patients themselves. Most often it is bacterial skin infections, which the patients lead to by scratching. Then it is necessary to use local antibiotics, and in the case of very extensive lesions, also oral antibiotics. As a result of self-injury, scars may also form, but only aesthetic medicine treatments can help to reduce them. As with the consequences of prolonged use of strong steroid ointments (e.g. dilated capillaries), which are sometimes used in patients complaining of persistent itching.
Treatment of parasitic insanity is based on pharmacotherapy with antipsychotics, in some cases in combination with antidepressants. How to get a person suffering from parasitic insanity to contact a psychiatrist? Patients usually do not listen to the advice of their relatives and are not convinced that their belief that they are infected is not right. Hearing that they require a psychiatric consultation, they react with aggression, because their belief that there are parasites under the skin is unquestionable. They try to get rid of the parasites on their own, which leads to self-harm. The condition for success is showing the patient a kind interest, because it is the lack of it that often leads to the development of the disorder. Only when the trust of this person is gained, one can take further steps leading to the implementation of effective therapy. A meeting with a psychologist can be helpful here, which is sometimes easier to convince than to visit a psychiatrist’s office right away. However, the most important thing is to surround the sick person with warmth and understanding and spend as much time as possible with them. Because it is loneliness that is the most important risk factor for the development of the disease and leads to exacerbation of symptoms.
Tekst: Leonard Logo
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