DermHelpCentral

Delusional Parasitosis

Delusional parasitosis is a monosymptomatic hypochondriacal state that causes great suffering for the patients and for those around them. Dermatologists are experts in the diagnosis ofcutaneous disease and frequently encounter such patients. This review provides an overview of the diagnosis and management of delusional parasitosis and the differential diagnosis.

These two references are thorough and helpful.

Download Ekbom Elston

Download Ekbom Jafferany

Prurigo and pets: the benefit from vets

Prurigo and pets: the benefit from vets
BMJ July 1979

The etiology of insect bites at times can be obscure.  Often, the source may be a pet.  One way to confirm the suspicion is to take a 3 - 4 mm punch biopsy.  If there are animals in the home, a veterinarian may be helpful.  The following article has stuck with me for decades.

Introduction: Cat and dog fleas cause pruritic papules in man, as do the mites Sarcoptes scabiei canis, Cheyletiella yasguri of dogs, and Cheyletiella blakei of cats. Flea and mite infestations are regularly seen in small-animal veterinary practice in Denmark, as in Britain. As these arthropods are rarely found on man Bagnall and Rook recommended that if a patient has unexplained prurigo all animal contacts should be examined. To assess the benefit from veterinary help we performed a parasitological examination of 143 animals who had contact with 111 patients with unexplained prurigo, controlled an transmissible ectoparasite, and then assessed the results.

See article. Prurigo BMJ PDF

This is a key article.  Classic in its own way.

Cheyletiella yasguri mite (cats, dogs, rabbits)

Head Lice: Wet Combing

German scientists examined 304 children at five primary schools that reported persistent head lice infestations. First, a researcher examined their scalps, parting the hair at five places where eggs or lice are often found. Then a different investigator, unaware of the results of the first test, examined the same children, this time wetting the hair with conditioner and running a fine-tooth comb from the scalp to the end of the hair.  The results appear in the March issue of The Archives of Dermatology.

This short NY Times article is a good jumping off place.

Scabies

Jane Brody wrote an important introduction to scabies in the September 23, 2008 NY Times.

"Scabies is frequently misdiagnosed and mistreated, partly because most physicians are unfamiliar with it and partly because its symptoms mimic so many other skin diseases.

A correct diagnosis is further complicated by the fact that symptoms can often appear six to eight weeks after a person becomes infested with the microscopic arthropod, making it seem as if the problem came from nowhere. But unlike other skin diseases, scabies is usually accompanied by a tell-tale sign: one or more burrows in the skin where female mites lay their eggs.

Scabies is easily cured, but only if patients and their close contacts conscientiously follow directions for medical treatment and environmental cleanup. However, even after a person is rid of the mites and their eggs, itching can persist for up to four weeks."

To read the full article click on "An Itchy Torment, Frequently Misdiagnosed."

Picture of mite taken from Stanford Medical School's article on Scabies.

Head Lice

Head lice are commonly seen.  You can read about them on Dermnet.

Pediatrician, Melanie Austin has a non-toxic over the counter approach for head lice.  It's time intensive but spares your child or you exposure to toxic chemicals. 

You can access her protocol at:  Download doc_austin_lice.pdf

The standard therapies, are fine, too. This is attached because many people prefer therapies that are less toxic.