Delusional parasitosis: what it is, causes and intervention

The skin is one of the most sensitive organs. For example, most people can feel an insect crawling on their arm. However, what if someone feels like there are bugs crawling on their body when there isn’t? In that case, we could be facing a disorder known as delusional parasitosis.

This disease is a rare form of psychosis, but it causes significant discomfort. Those who suffer from it live with the feeling that their skin is infested by small insects, which generates anxiety. In addition, it can compromise our health in other ways.

Formication and delusional parasitosis

The term “formication” refers to the sensation of having bugs crawling under or on the skin. This is a type of paresthesia that occurs when there is pressure on the nerves or alterations in the nervous system. It is usually known as the feeling of tingling, numbness, or numbness in a part of the body.

Following this line, formication can appear when, for example, we sleep on the arm and cut off blood flow. Then, we feel that our arm goes numb, giving us the sensation that there are ants walking on our skin. However, it is a temporary sensation and usually disappears when normal blood flow is restored.

Instead, Delusional parasitosis is an alteration that falls within the category of psychotic disorders.. Those who suffer from it have the delusion that there are small insects walking on or inside their skin; There is no evidence that this is the case and medical examinations do not reveal the presence of animals.

This condition is also known as delirium of infestation or Ekbom syndrome. The latter is named in honor of the neurologist Karl Ekbom, who described the disorder for the first time. Furthermore, he published studies on the matter from 1937 to 1938.

Delirium of infestation should not be confused with formication, because this is a paresthesia with organic causes.. Anyone who presents this symptom describes that they feel as if there are insects on their skin, but they know that this is not the case.

On the other hand, those who suffer from Ekbom syndrome believe that their skin is full of insects. This is precisely what they tell the doctor when they come for a consultation. “I feel ants on my skin, but I am not able to see them.”

Causes

To date, there is no known specific cause for delusional parasitosis. As with most mental disorders, it seems that multiple factors can influence the clinical picture. Some studies suggest that the alteration could be related to an excess of dopamine in the striatum of the brain.

Moriarty et al. (2019) published research on Ekbom syndrome. The authors point out that decreased activity of a protein called the “dopamine transporter” could cause the disorder. The incorrect function of this protein would reduce the reuptake of dopamine in the brain, generating an excess of it.

In the same way, The study explains that dopaminergic pathways participate in probability reasoning. Thus, the person can distinguish between benign stimuli and sensations that are dangerous for them.

Also, this same research mentions that MRI studies show alterations in the brain. In patients with delusional parasitosis, the areas that are responsible for evaluating probabilities and body perception have less volume.

At the same time, the consumption of drugs with the ability to alter dopaminergic pathways could cause delirium. Likewise, substance abuse and certain neurological disorders may be related to Ekbom syndrome.

Intervention

First, the specialist must do a complete evaluation in order to identify the possible cause of the delirium. For example, if the cause is substance abuse, then by eliminating use, symptoms should improve.

If there is no obvious cause, it is often assumed that it is a problem in the dopamine pathways in the brain. Thus, Your doctor may prescribe antipsychotics that have dopamine reuptake properties.. In this way, excess dopamine is eliminated and the remission of symptoms begins.

For severe cases, treatment may include a prescription for topical medications to treat skin problems. Due to delusional parasitosis, many patients scratch compulsively, causing lesions in the dermis. Therefore, there is a risk of infection that must be addressed as soon as possible.

Delusional parasitosis and Morgellons disease

Morgellons is the name given to a suspected skin disease in the early 2000s. The person who called her that was Mary Leitao, an American biologist whose young son had strange sores on his skin. According to her, colored fibers emerged from the sores that shone under the light.

After multiple evaluations, no doctor detected anything unusual on the child’s skin. In view of that, he decided to do his own research and described Morgellons syndrome. Those who suffer from it have lacerations on the skin in which colored fibers are found. Some time later, Leitao would create the Morgellons Research Foundation.

In 2012, the Center for Disease Control published the results of a study on the alleged disorder. Most patients with symptoms were found to be regular drug users, cognitively impaired, or exposed to irritants.

Furthermore, no trace of bacteria or microorganisms was found in the biopsies. Likewise, the fibers found in the lesions (caused by excessive scratching) correspond to cotton and other plant cellulose.

In conclusion, The CDC determined that Morgellons disease was a variation of delusional parasitosis. This is not a new condition, even though Mary Leitao and her foundation continue to claim otherwise.

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