Delusional parasitosis in dermatological practice

BACKGROUND: The accurate incidence of delusional parasitosis (DP) is difficult to assess. The aim of this study was to analyse the frequency of DP treated by dermatologists, and to evaluate the treatment modalities they applied. MATERIAL AND METHODS: A specially designed questionnaire was distributed to 172 dermatologists. A total of 118 doctors responded (68.6% of all subjects). The dermatologists were asked to answer questions concerning demographic data of the respondents and the frequency of DP observed in their everyday practice. Finally, methods of treatment used by the dermatologists to help patients suffering from DP were evaluated. RESULTS: During the whole working period the majority of dermatologists participating in the survey (84.7%) had seen at least one patient with DP in their practice. About one-third of the respondents (33%) had seen one or two cases of DP during the past 5 years, and 28% of the doctors treated from three to five such patients. Twenty-three per cent of dermatologists declared that they had diagnosed no cases of DP during the past 5 years. The rest of our respondents had seen more than five cases of DP during the past 5 years, and 7% of the doctors reported seeing more than 10 patients with DP within this period. Almost 20% of the dermatologists were currently treating a patient with DP. Our data show that 40.7% of the respondents always ask and 28.8% often ask for a psychiatric opinion about their patients with DP. More experienced dermatologists statistically more frequently (P<0.05) obtained a psychiatric opinion about their patients. Only a small group of dermatologists (15.3%) use their own pharmacological treatment. If they do so, they first use sedatives and anxiety-relieving drugs. CONCLUSION: DP is a quite common disorder, however not all dermatologists are sufficiently prepared to treat it. There is an urgent need for training on the dermatological approach to psychodermatoses.