Abstract
We report a case of 'delusional parasitosis by proxy'. A sixyear old child was brought
to the emergency department by a mother with concerns that her son had a skin and
scalp infestation. Despite the absence of any clinical findings being found on exam,
the mother remained disproportionately concerned. Follow up care was recommended with
the child's primary care. The mother returned to the ED with her child three weeks
later with concerns that her son had an inflamed scalp and eyes. The mother remained
insistent that the child was infested with bugs and she had sought care at two other
locations where the child was prescribed permethrin on both visits. She had been applying
the medication repeatedly. On exam the boy's scalp had been shaved and was erythematous
and irritated; his eyebrows and eyelashes had also been shaved off and likely contributed
to an irritant conjunctivitis from repeated applications of topical permethrin lotion.
No evidence of infestation was identified. We recruited the assistance of the maternal
grandparents, child protective services and primary care pediatrics and the child
was removed from the mother's custody and placed into the custody of the grandparents.
Six weeks later with basic skin care and erythromycin ophthalmic ointment for the
eyes, the child's hair, eyebrows and eyelashes grew had grown in, and the scalp irritation
had resolved. The mother had sought and received psychiatric care and was improving.
Keywords
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References
- Diagnosis and management of delusional parasitosis.J Am Acad Dermatol. 2019; 80: 1428-1434
- A population-based study of the incidence of delusional infestation in Olmsted County, Minnesota, 1976-2010.Br J Dermatol. 2014; 170: 1130-1135
- Delusional parisitosis by proxy.Clin Exp Derm. 2009; 34: e487-e488
Article Info
Publication History
Published online: May 30, 2019
Accepted:
May 29,
2019
Received:
May 13,
2019
Identification
Copyright
© 2019 Published by Elsevier Inc.
