Wednesday, October 24, 2012

Delusions of Parasitosis

The Ant
by Ogden Nash

The ant has made himself illustrious
Through constant industry industrious.
So what?
Would you be calm and placid
If you were full of formic acid?

If you really want to cast a curse on someone, instead of wishing that they might live in interesting times, as the Chinese do, you may wish they would develop delusions of parasitosis.  It's a nightmare for these patients, because they so completely believe that the lint, or hair follicles they pull out, or the occasional unlucky stray ant are imbedded in their skin, and they obsess  about them,  which drives them batty. Or, to be more accurate, battier. And they can't understand why you think they're wrong.

Examination reveals linear excoriations, but no primary lesions.  Often, they go from amateur to pro and develop prurigo nodules and ulcers.  This can be the only symptom of psychiatric disease, or it can present secondarily to bipolar illness, schizophrenia, anxiety disorders, and most commonly with obsessive states such as OCD.  

It usually occurs in white middle-aged or older women, although the condition has been reported in all age groups and in men.  Morgellon Disease describes a condition characterized by the delusion of fibers being attached to the skin. Morgellon's has become a new designation for delusions of parasitosis.

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