Delusional Dermatozoa

Delusional Dermatozoa Definition and Meaning

According to, a delusional dermatozoa is when the person concerned believes that they are infected with parasites such as insects under the skin. However, these only exist in his imagination.

What is delusional dermatozoa?

The delusional dermatozoa is one of the delusions and is also considered an organic psychosis. Those affected by this mental illness are absolutely convinced that there are insects or worms under their skin, which they can clearly feel through their movements. This in turn leads to anxiety or physical symptoms such as itching in the patient.

Clinical evidence for the parasite infestation cannot be found in the medical examinations, so that the alleged intruders only appear in the patients’ imaginations. Dermatozoa madness is also known as skin-animals madness, insect madness, acarophobia, parasitophobia or delusional vermin infestation. The term was coined by the Swedish neurologist Karl-Axel Ekbom (1907-1977), who described the disease in 1938.

For this reason the delusional dermatozoa is also known as Ekbom syndrome. A typical feature of the dermatozoal madness is the fact that even all medical examination results cannot convince the patient of his mistake. So he is of the firm opinion to be attacked by parasites and thus suffers terrible agony.

Some people even believe they can see the insects and collect supposed “evidence” such as skin particles, flakes of skin, fibers from textiles or grains of dust in order to be able to present them to doctors, relatives or friends. Exact numbers of how many people are sick with the dermatozoal madness are not available.

Another reason for this is that patients do not go to a psychologist or neurologist, but rather to a dermatologist or entomologist. For this reason, there are so far only a few psychiatric writings on this form of delusional belief. After all, it is known that women between the ages of 50 and 70 are predominantly affected by this mental disorder.


The causes of delusional dermatozoa vary. In addition to physically justifiable psychoses such as organically caused mental illnesses, endogenous psychoses, such as schizophrenia, can also be considered as triggers for the delusions. But purely emotional or psychosocial components can also cause delusional dermatozoa.

In the case of hallucinations, faulty signal transmissions occur. These mostly arise from disorders in the dopaminergic system within the central nervous system (CNS). The perception of the body is therefore not perceived as normal and the person concerned cannot differentiate between reality and delusions.

Therefore, she firmly believes in the phenomena that determine her perception. In addition, there is a disruption of tactile awareness, which also affects the perception of pain. The reasons for the disruption of the dopaminergic system have not yet been clarified. Sometimes withdrawal from drugs is also considered to be the trigger for dermatozoal madness.

In addition, hallucinations are often preceded by abuse of alcohol, amphetamines or cocaine. Injuries to the brain are also considered possible triggers. In medicine, a distinction is made between primary and secondary dermatozoal delusions. The primary form has no visible physical or psychological causes.

This pure dermatozoal delusion is basically a delusional disorder. Various dermatological, internal or neurological diseases as well as psychiatric diseases are responsible for the secondary form.

Symptoms, ailments & signs

The affected persons notice delusion of dermatozoa initially through skin sensation disorders. In doing so, they perceive parasites under their skin in their imagination, but they are not there at all. As it progresses, the delusional disorder solidifies and becomes systematic.

External observers cannot see anything unusual in the patient. However, the person affected feels significant symptoms such as itching and even pain. These symptoms are caused by the supposedly free-roaming insects. Because patients are constantly scratching themselves, this leads to real-world damage to the skin over time.


Diagnosing delusional dermatozoa is often not easy, as those affected are more likely to turn to a dermatologist than a psychiatrist. The dermatologist will do a thorough physical examination of the patient, but this will usually be inconclusive. If the condition worsens, it is advisable to consult a psychiatrist, which, however, is categorically rejected by most of those affected.

Patients think they are considered “crazy” or insane. Differentiation from other mental illnesses such as ego disorder or schizophrenia also plays an important role in the diagnosis. The course of the dermatozoal madness is difficult because the patients do not cooperate with the doctors. Instead, they collect supposed evidence to back up their theories about the disease.


In the case of delusional dermatozoa, there are mainly psychological complications that can have a very negative effect on the patient’s everyday life. In most cases, the patient will also report to other people that they have been infected with parasites and insects. This can seem bizarre and incomprehensible to other people, which can lead to social problems.

Social exclusion often occurs, which further exacerbates the symptom. At first, the disorder occurs only under the skin and leads to a feeling of being infected by parasites. This feeling restricts the person’s everyday life. Patients feel tired and exhausted and suffer from severe 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 deception causes the skin to be scratched, which can create wounds and scars. This permanently damages the skin.

In the worst case scenario, it leads to thoughts of suicide. Treatment is seldom successful, as the patient usually cannot be convinced that he is suffering from the delusional dermatozoa.

When should you go to the doctor?

If sensory disturbances are suddenly noticed on the skin that do not seem to have any identifiable cause, it may be delusional dermatozoa. The delusional disorder initially manifests itself as slight abnormal sensations that quickly develop into full-blown, but imagined complaints. Anyone who suspects such a disorder in themselves or others should consult a psychiatrist. First of all, a family doctor can clarify the symptoms and thus show the person concerned that it is an imaginary condition.

Since those affected are usually firmly convinced that the sensations are real suffering, a person of trust should be consulted if possible. People with a schizophrenic disorder are particularly susceptible to disorders such as delusional dermatitis.

They should speak to the responsible therapist or a family member if they have unusual symptoms. If necessary, the relatives must arrange for psychological counseling themselves. The patient then needs permanent support and should speak to a doctor regularly with regard to possible schizophrenia.

Treatment & Therapy

The treatment of delusional dermatozoa is not easy either. So the 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 dermatosis delusion is considered to be difficult to influence.

In extreme cases, patients become so desperate that they attempt suicide. If there is a clear diagnosis of delusional dermatitis, drug therapy with neuroleptics is carried out. In most cases, active ingredients such as risperidone, haloperidol and pimozide are used. So far, however, there are only a few studies on the effectiveness of these agents.

Outlook & forecast

The prognosis of the dermatozoal madness depends on various factors. A disease course that is only affected by the delusion for a short time is classified as favorable. If the underlying disease can be found and cured, there is also a good prospect of a cure. Overall, the prognosis is very much dependent on the willingness to cooperate and the reliability of the patient. If these prerequisites are met, the disease can be completely or partially remissioned.

In the worst case the delusional dermatozoa takes a chronic course and is considered untreatable. Patients with this course of the disease are significantly impaired by 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. Those affected see a doctor about the symptoms and accept the diagnosis. They also respond well to the treatment plan and are very willing to work with a therapist to resolve the causes. They are often treated with psychotherapy combined with medication. Depending on the cause, the healing process can take several years. Complete freedom from symptoms is possible, but must be assessed individually.


So far, there are no meaningful measures to prevent the dermatozoal madness. The exact triggers of the mental disorder have not yet been adequately clarified.


Since delusional dermatitis is usually relatively difficult to treat, the measures or options for follow-up care are also very limited. The person concerned is primarily dependent on rapid and direct treatment of this disease in order to prevent further complaints and complications.

Since self-healing is usually not possible, the focus of this disease is on early diagnosis with subsequent treatment. In the case of dermatozoal madness, it is also important that friends and relatives of the person concerned deal with the disease and deal with it.

You should support the person affected during treatment and help them with the disease. The treatment itself takes place with the help of a psychologist, whereby most of those affected also rely on taking medication. It is important to ensure that it is taken regularly and that the dosage is correct in order to permanently alleviate the symptoms.

In serious cases, relatives can persuade those affected by delusional dermatozoa to seek treatment in a closed clinic. In most cases, this disease does not reduce the life expectancy of those affected.

You can do that yourself

Dermatozoa is a serious mental illness that should be treated by a knowledgeable 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 person concerned is willing to therapy, a few things can be done in everyday life to ease the way out of this disease. To make it clear to the patient that they are not suffering from a parasite infestation, a stool examination could help. This would prove that the person concerned is healthy, because if the skin were infected with parasites, these would also be found in the intestines.

Parasites spread rapidly throughout the body. To counteract the constant itching, cooling ointments or gels, for example made from aloe vera, help. Antiseptic and anti-inflammatory ointments should be used on open skin and wounds. The preventive use of oily creams (linola) or lotions containing urea (urea) can also alleviate the symptoms.

If the accompanying depression is very pronounced and thoughts of suicide occur, medication should be given (antidepressants, neuroleptics). Relatives and friends can support those affected by not letting the self-chosen isolation deter them from regular visits. Maintaining social contacts is fundamentally important.

Delusional Dermatozoa

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