Ekbom syndrome II

Description

Ekbom syndrome or delusional parasitosis is characterised by;

• delusions in which an individual falsely believes they are infested by parasites.
• symptoms of formication; a sensation of insects crawling under skin
• signs including; matchbox sign – suffers often compulsively gather small particles of skin or fibres that they misinterpret as proof of infestation. Patient’s will store this ‘evidence’ in contains such as matchboxes in order to show to physicians.
• self-mutilation – patient will present with self inflicted skin markings such as excoriation of the skin, burn marks and scabs.

Additionally patients can be very resistant to the suggestion that there could be a psychiatric cause of their symptoms; patients often refuse treatment.

NOTE: acarophobia is the irrational fear of tiny bugs but – acrophobia is the fear of heights

History

1611-1677 James Harrington the English political theorist and author, argued by Lyell in his work on Delusions of parasitosis, to be the first recorded manifestation of delusional parasitosis

…he [Harrington] could talk rationally, and was excellent company; but he began to imagine that his sweat turned to flies, and sometimes to bees and other insects. He had a revolving summer house, lined with cloth, built in his garden, so that it could be turned towards the sun. The warmth would draw flies out of the cloth, and then he would cry: “Don’t you see that these flies come from me?“

Aubreys Brief Lives: [James Harrington p126]

1894 – Georges Thibierge (1856-1926), French dermatologist coined the term acarophobia to describe patients who were convinced they had mite infestations in the absence of clinical evidence. [1894; 3: 730-736]

1896 – Another French dermatologist, Léon Perrin (1853-1922) used the term névrodermies parasitophobiques [parasitophobic neurodermatosis] and described abnormalities both of cognition and perception. [1896; 7: 129–138]

1938 Ekbom published a case report in Acta Psychiatrica et Neurologica Scandinavica – Praeseniler Dermatzooenwahn – detailing 8 patients holding a delusional conviction that they were infested by parasites of the skin.

Associated Persons

• James Harrington (1611-77)
• John Aubrey (1626–1697)
• Karl-Axel Ekbom (1907-1977)
• Alan Lyell (1917-2007)

Alternative names

• Delusional parasitosis
• Delusion of parasitosis
• Ekbom’s syndrome

References

• Aubrey J. James Harrington. In: ‘Brief Lives’, chiefly of Contemporaries: 1669 to 1696; Volume I pg 124-127
• Thibierge G. Les acaraphobes. Annales de Dermatologie et de Syphiligraphie, 1894; 3: 730-736.
• Perrin L. Des névrodermies parasitophobiques. Annales de Dermatologie et de Syphiligraphie 1896; 7: 129–38
• Ekbom KA. Praeseniler Dermat-zooenwahn [The Pre-senile Delusion of Infestation]. Der praesenile Dermatozoenwahn. Acta Psychiatrica et Neurologica Scandinavica, 1938; 13, 227–59 [Translation Hist Psychiatry. 2003 Jun;14(54 Pt 2):229-56]
• Lyell A. Delusions of parasitosis. British Journal of Dermatology, 1983; 108: 485–99